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We studied the influence of birth size on hepatocellular lipid (HCL) concentrations in prepubertal children. Methods: A total of 195 prepubertal Caucasian children (4.4\u20139.7 years) were studied in three cohorts. Twenty-one children were born small-for-gestational-age (SGA), 132 were appropriate-for-gestational-age (AGA), and 42 were large-for-gestational-age (LGA). The outcomes were body fat by dual-energy X-ray absorptiometry (DXA), liver fat MRI and MR spectroscopy (MRS), anthropometric measurements at examination, and biochemical markers of metabolism and inflammation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      MRS revealed higher HCL in SGA children, as determined from the methylene (-CH\n                      <jats:sub>2<\/jats:sub>\n                      -) resonance (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). The high-sensitivity c-reactive protein (hs-CRP) level was also significantly higher in the SGA group than in the AGA (\n                      <jats:italic>p\u2009<\/jats:italic>\n                      =\u20090.01) or LGA groups (\n                      <jats:italic>p\u2009<\/jats:italic>\n                      =\u20090.002). The HCL concentrations were correlated with hs-CRP values in the whole cohort (\n                      <jats:italic>R\u2009<\/jats:italic>\n                      =\u20090.51,\n                      <jats:italic>p\u2009<\/jats:italic>\n                      =\u20090.03), independently of traditional anthropometric markers. Other laboratory parameters were not associated with HCL.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study shows a link between SGA status, elevated hs-CRP, and elevated MRS-detectable HCL. MRS may thus be important in identifying prepubertal children at risk for metabolic sequelae.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Prepubertal children born small-for-gestational-age (SGA), although still shorter and leaner than their peers, exhibit elevated liver triglyceride concentrations on proton MR spectroscopy associated with elevated hs-CRP levels.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Elevated hs-CRP and liver triglyceride concentrations can be early indicators of pathological metabolic changes associated with later cardiometabolic abnormalities.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41390-025-04464-5","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T17:47:40Z","timestamp":1760636860000},"page":"1920-1926","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Children born small-for-gestational-age exhibit normal body fat but elevated hs-CRP and hepatocellular lipid content"],"prefix":"10.1038","volume":"99","author":[{"given":"Leena","family":"Hintikka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jarmo","family":"J\u00e4\u00e4skel\u00e4inen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riina","family":"Palonen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrikki","family":"Nordman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raimo","family":"Voutilainen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Huopio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomi","family":"Laitinen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7341-5440","authenticated-orcid":false,"given":"Juhana","family":"Hakum\u00e4ki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"4464_CR1","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1007\/s13224-019-01278-4","volume":"70","author":"D Shrivastava","year":"2020","unstructured":"Shrivastava, D. & Master, A. 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