Features of body composition in children with obesity and non-alcoholic fatty liver disease

Obesity is recognized as a global problem, and its prevalence has reached pandemic proportions. Obesity has been found to be a significant risk factor for the development and progression of various pathologies, including NAFLD. Objective. To determine the features of body composition in children with exogenous-constitutional obesity depending on the presence or absence of NAFLD. Materials and methods. The study included 103 children of both sexes (58 boys and 45 girls) aged 12 to 17 years with exogenous-constitutional obesity (SDS BMI> +2.0). Patients were randomized into two age- and gender-matched groups: Group 1 - children with obesity and NAFLD (n = 51), Group 2 - children with obesity without NAFLD (n = 52). Results. In group 1, a reliable predominance of higher values of BMI (Me 34.7 [30.8; 38.2] versus Me 30.5 [28.55; 33.1], p=0.0002) and SDS BMI (Me 3.1 [2.66; 3.69] versus Me 2.74 [2.37; 3.06], p=0.0004) was revealed compared to group 2. Children in group 1 were characterized by statistically significantly higher indicators: FM (Me 39.6 [32.3; 48,1] versus Me 31.65 [26.8; 38.95], p=0.002); IFM (Me 22.6 [16.6; 33.1] vs. Me 16.850 [13.0; 23,7] p=0.004); TM (Me 60.0 [50.1; 70.0] vs. Me 50.50 [45.45; 56.95], p=0.0003); ACM (Me 32.2 [27.2; 37.8] versus Me 27.05 [24.15; 31,55], p=0.0005) and SMM (Me 26.9 [22.7; 33,6] versus Me 23.35 [21.05; 29,2], p=0.02); 36.95 [33.25; 41,65], p=0.0003) and BF (Me18.1 [15.6; 20.8] versus Me 15.6 [14.15; 17.45], p=0.0002). Conclusions. According to bioimpedance analysis, children with exogenous-constitutional obesity and signs of NAFLD have more pronounced changes in body composition, both its fat and lean components, compared to children without NAFLD.

obesity, NAFLD, non-alcoholic fatty liver disease, bioimpedance analysis, body composition, children

1. Resolution WHA65.6.Comprehensive implementation plan on maternal, infant and young child nutrition. In: Sixty-fifth World Health Assembly Geneva, 21-26 May 2012. Resolutions and decisions, annexes. Geneva: World Health Organization; 2012:12-13

2. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet. 2024;403(10431):1027-1050. doi:10.1016/S0140-6736(23)02750-2.

3. Bokova Т.А., Shishulina E.E., Bevz А.S., Kartashova D.A.Comparative analysis concerning the prevalence of childhood obesity in the Moscow region.Russian Journal of Woman and Child Health. 2024;7(1):51-57 (in Russ.). doi: 10.32364/2618-8430-2024-7-1-8.@@ Бокова Т.А., Шишулина Е.Е., Бевз А.С., Карташова Д.А. Сравнительный анализ заболеваемости ожирением детей, проживающих в Московской области. РМЖ. Мать и дитя. 2024;7(1):51-57. doi: 10.32364/2618-8430-2024-7-1-8.

4. Bondareva E.A., Troshina E.A. Obesity. Reasons, features and prospects. Obesity and metabolism. 2024;21(2):174-187. (In Russ.) doi: 10.14341/omet13055.@@ Бондарева Э.А., Трошина Е.А. Ожирение. Причины, типы и перспективы. Ожирение и метаболизм. 2024;(2):174-187. doi: 10.14341/omet13055.

5. Smith J.D., Fu E., Kobayashi M.A. Prevention and Management of Childhood Obesity and Its Psychological and Health Comorbidities. Annu Rev Clin Psychol. 2020 May 7;16:351-378. doi: 10.1146/annurev-clinpsy-100219-060201.

6. Anderson E.L., Howe L.D., Jones H.E. et al. The Prevalence of Non-Alcoholic Fatty Liver Disease in Children and Adolescents: A Systematic Review and Meta-Analysis. PLoS One. 2015 Oct 29;10(10): e0140908. doi: 10.1371/journal.pone.0140908.

7. Bokova T.A. Non-alcoholic fatty liver disease in children: relationship with the main components of metabolic syndrome in children. Experimental and Clinical Gastroenterology. 2020;(1):15-20.(In Russ.) doi: 10.31146/1682-8658-ecg-173-1-15-20.@@ Бокова Т.А. Неалкогольная жировая болезнь печени и основные компоненты метаболического синдрома у детей. Экспериментальная и клиническая гастроэнтерология. 2020;(1):15-20. doi: 10.31146/1682-8658-ecg-173-1-15-20.

8. Younossi Z., Tacke F., Arrese M. et al. Global Perspectives on Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis. Hepatology. 2019 Jun;69(6):2672-2682. doi: 10.1002/hep.30251.

9. Nikolaev D.V., Shchelykalina S.P. Lectures on bioimpedance analysis of the composition of the human body. RIO CNIIOIZ MZ RF. Moscow, 2016. 152 p. (In Russ.)@@ Николаев Д.В., Щелыкалина С.П. Лекции по биоимпедансному анализу состава тела человека. М.: РИО ЦНИИОИЗ МЗ РФ; 2016: 152.

10. Wan Q., Liu X., Xu J. et al. Body Composition and Progression of Biopsy-Proven Non-Alcoholic Fatty Liver Disease in Patients with Obesity. J Cachexia Sarcopenia Muscle. 2024 Dec;15(6):2608-2617. doi: 10.1002/jcsm.13605.

11. Kang M.K., Baek J.H., Kweon Y.O. et al. Association of Skeletal Muscle and Adipose Tissue Distribution with Histologic Severity of Non-Alcoholic Fatty Liver. Diagnostics (Basel). 2021 Jun 9;11(6):1061. doi: 10.3390/diagnostics11061061.

12. Peterkova V.A., Bezlepkina O.B., Bolotova N.V. et al. Clinical guidelines «Obesity in children». Problems of Endocrinology. 2021;67(5):67-83. (In Russ.) doi: 10.14341/probl12802.@@ Петеркова В.А., Безлепкина О.Б., Болотова Н.В. и др. Ожирение у детей. Клинические рекомендации. Проблемы Эндокринологии. 2021;67(5):67-83. doi: 10.14341/probl12802.

13. Chen Y., Wang W., Morgan M.P. et al. Obesity, non-alcoholic fatty liver disease and hepatocellular carcinoma: current status and therapeutic targets. Front Endocrinol (Lausanne). 2023 Jun 8;14:1148934. doi: 10.3389/fendo.2023.1148934.

14. Bokova T.A. Non-alcoholic fatty liver disease in children with obesity and metabolic syndrome. Attending physician. 2019;(1):28-31. (In Russ.)@@ Бокова Т.А. Неалкогольная жировая болезнь печени у детей с ожирением и метаболическим синдромом. Лечащий врач. 2019;(1):28-31.

15. Smith J.D., Montaño Z., Maynard A., Miloh T. Family Functioning Predicts Body Mass Index and Biochemical Levels of Youths with Nonalcoholic Fatty Liver Disease. J Dev Behav Pediatr. 2017 Feb-Mar;38(2):155-160. doi: 10.1097/DBP.0000000000000379.

16. Pavlovskaya E.V., Strokova T.V., Taran N.N. et al. Characteristics of body composition in obese children depending on comorbid pathology. Children’s Medicine of the North-West. 2022;10(1): 62-69. (In.Russ.)@@ Павловская Е.В., Строкова Т.В., Таран Н.Н. и др. Характеристика состава тела у детей с ожирением в зависимости от коморбидной патологии. Children’s Medicine of the North-West. 2022;10(1): 62-69.

17. Chen M., Liu J., Ma Y. et al. Association between Body Fat and Elevated Blood Pressure among Children and Adolescents Aged 7-17 Years: Using Dual-Energy X-ray Absorptiometry (DEXA) and Bioelectrical Impedance Analysis (BIA) from a Cross-Sectional Study in China.Int J Environ Res Public Health. 2021; 18(17): 9254. doi: 10.3390/ijerph18179254.

18. Rujirakan P., Siwarom S., Paksi W. et al. Masked hypertension and correlation between body composition and nighttime blood pressure parameters in children and adolescents with obesity. Blood Press Monit. 2021. doi: 10.1097/MBP.0000000000000555.

19. Kari A.E., Evdokimova N.V. Features of body composition in children with different degrees of obesity. Children’s Medicine of the North-West (St. Petersburg). 2024;12(1):107-113. doi: 10.56871/CmN-W.2024.29.16.011.@@ Кари, А. Е., Евдокимова, Н.В. Особенности композиционного состава тела у детей с различной степенью ожирения. Детская медицина Северо-Запада. 2024;12(1):107-113. doi: 10.56871/CmN-W.2024.29.16.011.

20. Rudnev S.G., Soboleva N.P., Sterlikov S.A. et al. Bioimpedance Study of the Body Composition of the Russian Population. Moscow: Central Research Institute for Organization and Informatization of Health. 2014. 493 р. (In Russ.)@@ Руднев С.Г., Соболева Н.П., Стерликов С.А. и др. Биоимпедансное исследование состава тела населения России. М.: Центральный научно-исследовательский институт организации и информатизации здравоохранения. 2014. с. 493.

21. Girsh Ya.V., Gerasimchik O.A. The Role and Place of Bioimpedance Analysis Assessment of Body Composition of Children and Adolescents with Different Body Mass. Byulleten’ sibirskoj mediciny = Bulletin of Siberian medicine. 2018;17(2):121-132. (In Russ.)@@ Гирш Я.В., Герасимчик О.А. Роль и место биоимпедансного анализа в оценке состава тела детей и подростков с различной массой тела. Бюллетень сибирской медицины. 2018;17(2):121-132.

22. Prosecky R., Kunzova S., Kovacovicova P. et al. Association of anthropometric and body composition parameters with the presence of hypertension in the Central European population: results from KardioVize 2030 study. Acta Cardiol. 2023;78(5):614-622. doi: 10.1080/00015385.2023.2192153.