Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.
Nutrition and Health Sciences Doctoral Program, Laney Graduate School, Atlanta, Georgia, USA.
Pediatr Obes. 2021 Aug;16(8):e12773. doi: 10.1111/ijpo.12773. Epub 2021 Feb 8.
The importance of body fat distribution in the development of nonalcoholic fatty liver disease (NAFLD) is unclear.
To examine whether total and truncal fat deposition patterns in childhood/adolescence are associated with NAFLD risk at 24 years.
Data were from 1657 participants in the Avon Longitudinal Study of Parents and Children. Transient elastography was used to assess hepatic steatosis (low/moderate/severe) at 24 years and dual-energy X-ray absorptiometry was used to assess total body fat percent (TBF%) and trunk fat percent (TrF%) at 9, 13, 15, 17, and/or 24 years. Linear mixed models were constructed with quadratic age to examine trajectories of TBF% and TrF% by steatosis at 24 years, adjusting for confounders.
In both sexes, TBF% trajectories from 9 to 24 years followed a similar pattern based on steatosis group (P = .83 for boys and P = .14 for girls for age *steatosis fixed effect). However, at all ages TBF% was higher for moderate/severe vs low steatosis at 24 years (P < .05). In contrast, TrF% trajectories diverged based on steatosis group (P = .001 for boys and P = .0002 for girls for age *steatosis fixed effect), such that, in both sexes, participants with moderate/severe steatosis at 24 yrs exhibited less decline in TrF% from adolescence to adulthood compared to participants with low steatosis at 24 yrs. Similar to TBF%, TrF% was higher at nearly all ages for moderate/severe vs low steatosis. Results were similar after adjusting for BMI category at each age, except in boys some differences for TrF% were attenuated.
These findings suggest that sex-specific body fat distribution patterns in childhood/adolescence may help to identify those at risk of developing NAFLD in adulthood.
体脂分布在非酒精性脂肪性肝病（NAFLD）发展中的重要性尚不清楚。
研究儿童/青少年时期的总体和躯干脂肪沉积模式与 24 岁时 NAFLD 风险的关系。
本研究数据来自阿冯纵向研究父母和孩子的 1657 名参与者。瞬态弹性成像用于评估 24 岁时的肝脂肪变性（低/中/重度），双能 X 射线吸收法用于评估总体脂肪百分比（TBF%）和躯干脂肪百分比（TrF%）在 9、13、15、17 和/或 24 岁时。构建线性混合模型，采用二次年龄来检查 24 岁时脂肪变性的 TBF%和 TrF%轨迹，调整混杂因素。
在两性中，9 岁至 24 岁的 TBF%轨迹根据脂肪变性组呈现相似的模式（男孩 P =.83，女孩 P =.14，用于年龄脂肪变性固定效应）。然而，在所有年龄段，中度/重度脂肪变性的 TBF%均高于 24 岁时的轻度脂肪变性（P <.05）。相比之下，TrF%轨迹根据脂肪变性组而有所不同（男孩 P =.001，女孩 P =.0002，用于年龄脂肪变性固定效应），因此，在两性中，24 岁时中度/重度脂肪变性的参与者在青春期到成年期的 TrF%下降幅度小于 24 岁时轻度脂肪变性的参与者。与 TBF%相似，TrF%在几乎所有年龄段均高于中度/重度脂肪变性。调整每个年龄的 BMI 类别后，结果相似，但男孩的一些 TrF%差异减弱。
这些发现表明，儿童/青少年时期特定性别的体脂分布模式可能有助于识别成年后患 NAFLD 的风险人群。
