Longitudinal Links between Changes in Body Composition and Liver Disease Severity in Children and Adolescents with Metabolic Dysfunction-Associated Steatotic Liver Disease - 11/12/24
Abstract |
Objective |
To investigate the relationship between longitudinal changes in body composition and liver disease severity in children with metabolic dysfunction-associated steatotic liver disease (MASLD).
Study design |
This longitudinal, single-center, retrospective analysis included patients aged <20 years followed for MASLD who had had ≥2 bioelectrical impedance analyses (BIAs) performed. MASLD regression was defined as alanine aminotransferase (ALT) normalization or a decrease of >50% from baseline. Fat and skeletal muscle mass were adjusted for size by calculating respective indices (dividing by height2). Logistic and linear regressions were used to determine the independent relationship between changes in body composition over time and serological markers of liver disease severity.
Results |
We included 258 patients (75% male, 50% Hispanic) with a median age of 14 years (IQR, 11-16 years) at the time of first BIA. Median body mass index (BMI) z-score at baseline was 2.33 (IQR, 2.04-2.62). Median time from first to last BIA was 12 months (IQR, 6-24 months). A decrease in fat mass index was independently associated with reductions in ALT and gamma glutamyl transferase and increased odds of MASLD regression (OR; 0.55; P < .001). Fat mass index reduction was superior to BMI z-score in predicting MASLD regression. Change in skeletal muscle mass index was not associated with change in ALT or gamma glutamyl transferase.
Conclusions |
Changes in fat mass, not skeletal muscle mass, are associated with serological markers of liver injury in youth with MASLD. Fat mass changes outperform BMI z-score changes in predicting MASLD regression. BIA can serve as an adjunct biomarker of liver disease progression.
Le texte complet de cet article est disponible en PDF.Keywords : Bioelectrical impedance, muscle mass, fat mass, steatosis, pediatrics, NAFLD
Abbreviations : ALT, GGT, BIA, BMI, GLP-1, HbA1c, MASLD, MASH, MRI
Plan
| Supported in part by NIH P30 DK078392 (Clinical Component) of the Digestive Diseases Research Core Center in Cincinnati. |
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| Dr. Mouzaki conceived the study, which was designed with additional input from Dr. Xanthakos. Dr. Fei led the statistical analyses. All authors contributed to data acquisition, critically reviewed the work for important intellectual content, provided final approval of the version to be published and agreed to be accountable for all aspects of the work. |
Vol 276
Article 114301- janvier 2025 Retour au numéro
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