Impedance-based measures of muscle mass can be used to predict severity of hepatic steatosis in pediatric nonalcoholic fatty liver disease.

Abstract Objective The objective of this study was to investigate the association between bioelectrical impedance (BIA)-based measures of body composition and histologic liver disease severity in a pediatric cohort with nonalcoholic fatty liver disease (NAFLD). Methods Cross-sectional study of patients Results Of the 79 included children (73% male, 38% Hispanic, median age 13 years, median BMI z 2.43), the median NAFLD Activity Score (NAS) was 4 (IQR 3, 5). In multivariable regression analyses, SMM index was negatively associated with hepatic steatosis after controlling for confounders (OR 0.76; 95%CI, 0.62 – 0.93). Similarly, AMM index was negatively associated with hepatic steatosis severity (OR 0.69; 95%CI, 0.53 – 0.90). In contrast, percent body fat was not associated with hepatic steatosis. NAS, lobular inflammation, ballooning scores and fibrosis stage were not associated with measures of body composition. Conclusions There is an inverse association between BIA-based measures of muscle mass and hepatic steatosis severity in children with NAFLD. BIA data could further inform clinical decision-making in this context.