Liver fat, bone marrow adipose tissue and bone mineral density in children with overweight.

Hepatic steatosis is associated with decreased bone mineral density (BMD). Bone marrow fat fraction (BMFF) could play a role on this relationship in children with obesity. The objectives were: (i) to examine the relationship between the lumbar spine (LS) BMFF and BMD, and (ii) to explore the mediating role of LS-BMFF on the relationship between percentage hepatic fat with LS-BMD in preadolescent children with overweight/obesity. Hepatic fat and LS-BMFF (magnetic resonance imaging) and areal LS-BMD (LS-aBMD, dual X-ray absorptiometry) were measured in 106 children (10.6 ± 1.1 years, 53.8% girls) with overweight/obesity. LS-BMFF was inversely associated with LS-aBMD (r = -0.313, P = 0.001) and directly related with percentage hepatic fat (r = 0.276, P = 0.005). LS-BMFF was significantly greater in children with than without hepatic steatosis (P = 0.003, Cohen´s d: 0.61, 95%CI -0.21 to 1.0), while no significant difference was seen between children with overweight and those with obesity (P = 0.604; Cohen's d: 0.16, 95% CI -0.21-0.55). Mediating analysis indicated that LS-BMFF is an important mediator (50%) in the association of hepatic fat with lower LS-aBMD (indirect effect: β=-0.076, 95%CI -0.143 to -0.015). These findings suggest that hepatic steatosis, rather than overall excess adiposity, is associated with greater bone marrow adipose tissue in preadolescent children with overweight/obesity, which in turn, is related to a lower BMD. Hepatic steatosis could be a potential biomarker of osteoporosis risk, and a therapeutic target for interventions that aim to reduce not only hepatic steatosis, but for those designed to improve bone health in such children.

Informations de copyright

© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: [e-mail].