Higher BMI z-score was associated with increased odds of elevated UDFF, with ultrasound-measured abdominal wall thickness being the strongest predictor of hepatic fat content.
Is BMI z-score associated with ultrasound-derived fat fraction (UDFF) in children without underlying liver disease?
Ultrasound-derived fat fraction (UDFF) and abdominal wall thickness are valuable non-invasive markers associated with adiposity and early hepatic fat accumulation in children.
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BACKGROUND: Childhood obesity is rising worldwide, leading to an increased prevalence of metabolic dysfunction-associated steatotic liver disease, the most common pediatric liver disease. Ultrasound-derived fat fraction (UDFF) is a recently developed technique for quantifying hepatic fat that has been validated in children, providing a rapid, reliable, and non-invasive alternative to conventional imaging. OBJECTIVE: To evaluate the association between weight status, expressed as body mass index (BMI) z-score, and UDFF in a pediatric population without underlying liver disease. MATERIALS AND METHODS: Abdominal ultrasounds including a UDFF measurement in patients without liver disease were retrospectively evaluated. We calculated the BMI z-score for all patients and classified them as normal weight (zBMI) or overweight (zBMI≥1). UDFF values were compared across zBMI categories, sex and ethnicity (Hispanic/Latino or non-Hispanic/non-Latino), using chi-square tests (P6%) and adiposity markers (zBMI and ultrasound-measured abdominal wall thickness (AWT)), as well as ethnicity. RESULTS: Of 223 subjects, 93 (41 males/52 females, mean age of 8.2 years) met the inclusion criteria. In the normal-weight population (n=46), 41 (89.1%) had normal UDFF, and 5 (10.9%) had elevated UDFF. In the overweight group (n =47), 29 (61.7%) had normal UDFF and 18 (38.3%) had elevated UDFF. UDFF values showed a positive correlation with zBMI, and higher zBMI increased the odds of elevated UDFF. In the multivariable model including zBMI, AWT, and ethnicity, ultrasound-measured abdominal wall thickness was the strongest predictor of elevated UDFF. CONCLUSION: BMI z-score was positively associated with hepatic fat content and with higher odds of elevated UDFF. When multiple factors were considered together, ultrasound-measured abdominal wall thickness showed the strongest independent association with elevated UDFF supporting the central role of adiposity in pediatric hepatic fat accumulation. UDFF may serve as a valuable complement to routine clinical markers, using zBMI, for early identification of children with hepatic steatosis. Larger prospective studies are needed to define its role in clinical practice.
Moeremans et al. (Tue,) reported a other. Higher BMI z-score was associated with increased odds of elevated UDFF, with ultrasound-measured abdominal wall thickness being the strongest predictor of hepatic fat content.
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