{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:22:32Z","timestamp":1790709752001,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To explore the relationships between body composition, indices of hepatic fibrosis, and sonographic evidence of hepatic steatosis in children with overweight and obesity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred and seventy individuals (age 12.7\u2009\u00b1\u20093.4\u2009years, 38.2% boys) with overweight\/obesity (BMI <jats:italic>z<\/jats:italic>\u2010score 2.02\u2009\u00b1\u20090.54) underwent bioelectrical impedance analysis (fat percentage, truncal\u2010to\u2010total fat ratio, muscle\u2010to\u2010fat ratio [MFR]). Hepatic assessments included ultrasonography to detect liver steatosis, alanine transaminase (ALT), aspartate aminotransferase (AST)\/ALT ratio, and nonalcoholic fatty liver disease fibrosis score (NFS). A forward logistic regression model, adjusting for sex, age, and socio\u2010economic position, was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The odds for sonographic hepatic steatosis increased by 3.8\u2010fold for each SD decrease in MFR <jats:italic>z<\/jats:italic>\u2010score (OR\u2009=\u20090.263, 95% CI [0.067\u20131.031], <jats:italic>p<\/jats:italic>\u2009=\u20090.05). The strongest correlation among boys was between MFR <jats:italic>z<\/jats:italic>\u2010score and AST\/ALT ratio (<jats:italic>r<\/jats:italic>\u2009=\u20090.530, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), whereas the strongest correlation among girls was between fat percentage and NFS (<jats:italic>r<\/jats:italic>\u2009=\u20090.503, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Individuals with sonographic hepatic steatosis had higher fat mass (<jats:italic>p<\/jats:italic>\u2009=\u20090.003), lower MFR <jats:italic>z<\/jats:italic>\u2010score (<jats:italic>p<\/jats:italic>\u2009=\u20090.020), greater insulin resistance (<jats:italic>p<\/jats:italic>\u2009=\u20090.018), and atherogenic dyslipidemic index (<jats:italic>p<\/jats:italic>\u2009=\u20090.037) compared to those without.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We identified sex differences in the association between body composition and hepatic fibrosis indices. The relationship between adverse body composition and increased odds of hepatic steatosis underscores the importance of its assessment within this at\u2010risk population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.70026","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T05:46:10Z","timestamp":1739425570000},"page":"1709-1719","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Sex Differences in Body Composition and MASLD in Children With Overweight and Obesity"],"prefix":"10.1111","volume":"114","author":[{"given":"Adi","family":"Uretzky","sequence":"first","affiliation":[{"name":"The Institute of Pediatric Endocrinology, Diabetes and Metabolism Dana\u2010Dwek Children's Hospital, Tel Aviv Sourasky Medical Center  Tel Aviv Israel"},{"name":"The School of Medicine, Faculty of Medical &amp; Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0083-9443","authenticated-orcid":false,"given":"Eyal","family":"Cohen\u2010Sela","sequence":"additional","affiliation":[{"name":"The Institute of Pediatric Endocrinology, Diabetes and Metabolism Dana\u2010Dwek Children's Hospital, Tel Aviv Sourasky Medical Center  Tel Aviv Israel"},{"name":"The School of Medicine, Faculty of Medical &amp; 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