Longitudinal associations of total and trunk fat in childhood and adolescence and risk of hepatic steatosis at 24 years

Summary Background The importance of body fat distribution in the development of nonalcoholic fatty liver disease (NAFLD) is unclear. Objective To examine whether total and truncal fat deposition patterns in childhood/adolescence are associated with NAFLD risk at 24 years. Methods 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. Results 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 2 *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 2 *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. Conclusions 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.