{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:53:12Z","timestamp":1787014392800,"version":"build-2736575974"},"reference-count":49,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T00:00:00Z","timestamp":1602633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Obesity"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Eighty percent of adolescents with severe obesity suffer from non\u2010alcoholic fatty liver disease (NAFLD). Non\u2010invasive prediction models have been tested in adults, however, they performed poorly in paediatric populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to investigate novel biomarkers for NAFLD and to develop a score that predicts liver fat in youth with severe obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      From a population with a BMI &gt;97th percentile aged 9\u201019\u2009years (\n                      <jats:italic>n<\/jats:italic>\n                      = 68), clinically thoroughly characterized including MRI\u2010derived proton density fat fraction (MRI\u2010PDFF), amino acids and acylcarnitines were measured by HPLC\u2010MS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In children with NAFLD, higher levels of plasma branched\u2010chain amino acids (BCAA) were determined. BCAAs correlated with MRI\u2010PDFF (\n                      <jats:italic>R<\/jats:italic>\n                      = 0.46,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.01). We identified a linear regression model adjusted for age, sex and pubertal stage consisting of BCAAs, ALT, GGT, ferritin and insulin that predicted MRI\u2010PDFF (\n                      <jats:italic>R<\/jats:italic>\n                      = 0.75,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.01). ROC analysis of this model revealed AUCs of 0.85, 0.85 and 0.92 for the detection of any, moderate and severe steatosis, respectively, thus markedly outperforming previously published scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>BCAAs could be an important link between obesity and other metabolic pathways. A BCAA\u2010based metabolic score can predict steatosis grade in high\u2010risk children and adolescents and may provide a feasible alternative to sophisticated methods like MRI or biopsy in the future.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijpo.12739","type":"journal-article","created":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T20:37:29Z","timestamp":1602707849000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["A branched\u2010chain amino acid\u2010based metabolic score can predict liver fat in children and adolescents with severe obesity"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7047-3829","authenticated-orcid":false,"given":"Julia","family":"Lischka","sequence":"first","affiliation":[{"name":"Clinical Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine Medical University of Vienna  Vienna Austria"},{"name":"Comprehensive Center for Pediatrics, Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Schanzer","sequence":"additional","affiliation":[{"name":"Clinical Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine Medical University of Vienna  Vienna Austria"},{"name":"Comprehensive Center for Pediatrics, Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azadeh","family":"Hojreh","sequence":"additional","affiliation":[{"name":"Comprehensive Center for Pediatrics, Medical University of Vienna  Vienna Austria"},{"name":"Department of Biomedical Imaging and Image\u2010guided Therapy Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Ba Ssalamah","sequence":"additional","affiliation":[{"name":"Department of Biomedical Imaging and Image\u2010guided Therapy Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chike Bellarmine","family":"Item","sequence":"additional","affiliation":[{"name":"Clinical Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3692-8754","authenticated-orcid":false,"given":"Charlotte","family":"de Gier","sequence":"additional","affiliation":[{"name":"Clinical Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine Medical University of Vienna  Vienna Austria"},{"name":"Comprehensive Center for Pediatrics, Medical University of Vienna  Vienna 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