title: Liver fat content investigated by magnetic resonance spectroscopy in obese children and youths included in multidisciplinary treatment.
abstract: What is already known about this subject •  Investigations of non-alcoholic fatty liver disease (NAFLD) by non-invasive imaging procedures have limited evidence. •  Thirty percent of obese children are estimated to have NAFLD and implications for future morbidity are uncertain. What this study adds •  Many obese children and youths exhibit a high liver fat content as examined by magnetic resonance spectroscopy. •  Associations between liver fat content, anthropometry, abdominal adipose tissue distribution and liver enzymes are illustrated.
  
  
  CONCLUSIONS
  The study aims to investigate the degree of hepatic steatosis and associations with the amount of abdominal subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), anthropometric data and biochemical measures of liver enzymes in children and youths included in obesity treatment. The study included 164 patients, aged 6-20 years, with a body mass index (BMI) above the 90th percentile for sex and age. Liver fat content was measured by magnetic resonance spectroscopy (MRS). SAT and VAT were measured by magnetic resonance imaging. Hepatic steatosis was defined as liver fat content >5% (steatosis-5%) and 9% (steatosis-9%), respectively. Data on waist circumference (WC) and blood samples were available in 124 patients. Steatosis-5% and steatosis-9% were identified in 45% and 27% of the patients, respectively. These patients had increased SAT, VAT, BMI standard deviation score, WC/height ratio, alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) levels. GGT, ALT and VAT were found to be independent risk factors of hepatic steatosis. In this study, a substantial proportion of obese children and youths have hepatic steatosis. Therefore, it is important to examine these subjects for the degree of fat in their liver. Future studies focusing on hepatic steatosis should consider the use of MRS in addition to blood samples.
authors.affiliation: The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbaek, Holbaek, DenmarkThe Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health Sciences, University of Copenhagen, Copenhagen, DenmarkDepartment of Diagnostic Radiology, Copenhagen University Hospital Herlev, Herlev, DenmarkInstitute of Preventive Medicine, Copenhagen University Hospital, Copenhagen, DenmarkDepartment of Diagnostic Sciences, Faculty of Health Sciences, University of Copenhagen, Copenhagen, DenmarkFaculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: D S
authors.initials: DS
authors.lastname: Bille
authors.forename: E
authors.initials: E
authors.lastname: Chabanova
authors.forename: M
authors.initials: M
authors.lastname: Gamborg
authors.forename: C E
authors.initials: CE
authors.lastname: Fonvig
authors.forename: T R H
authors.initials: TR
authors.lastname: Nielsen
authors.forename: E
authors.initials: E
authors.lastname: Thisted
authors.forename: H S
authors.initials: HS
authors.lastname: Thomsen
authors.forename: J-C
authors.initials: JC
authors.lastname: Holm
keywords: Child; hepatic steatosis; magnetic resonance spectroscopy; obesity