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Bone marrow fat fraction (BMFF) could play a role in this relationship in children with obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objectives of this work were (i) to examine the relationship between the lumbar spine (LS) BMFF and BMD, and (ii) to explore the mediating role of LS-BMFF on the relationship between percentage hepatic fat with LS-BMD in preadolescent children with overweight\/obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Hepatic fat and LS-BMFF (magnetic resonance imaging) and areal LS-BMD (LS-aBMD, dual-energy x-ray absorptiometry) were measured in 106 children (aged 10.6 \u00b1 1.1 years, 53.8% girls) with overweight\/obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>LS-BMFF was inversely associated with LS-aBMD (r = \u22120.313; P = .001) and directly related with percentage hepatic fat (r = 0.276; P = .005). LS-BMFF was significantly greater in children with than without hepatic steatosis (P = .003; Cohen's d: 0.61; 95% CI, \u22120.21 to 1.0), while no significant difference was seen between children with overweight and those with obesity (P = .604; Cohen's d: 0.16; 95% CI, \u22120.21-0.55). Mediating analysis indicated that LS-BMFF is an important mediator (50%) in the association of hepatic fat with lower LS-aBMD (indirect effect: \u03b2 = \u2212.076; 95% CI, \u22120.143 to \u22120.015).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings suggest that hepatic steatosis, rather than overall excess adiposity, is associated with greater bone marrow adipose tissue in preadolescent children with overweight\/obesity, which in turn, is related to lower BMD. Hepatic steatosis could be a potential biomarker of osteoporosis risk, and a therapeutic target for interventions that aim to reduce not only hepatic steatosis, but for those designed to improve bone health in such children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgad429","type":"journal-article","created":{"date-parts":[[2023,7,21]],"date-time":"2023-07-21T18:40:08Z","timestamp":1689964808000},"page":"e253-e258","source":"Crossref","is-referenced-by-count":18,"title":["Liver Fat, Bone Marrow Adipose Tissue, and Bone Mineral Density in Children With Overweight"],"prefix":"10.1210","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4334-3287","authenticated-orcid":false,"given":"Idoia","family":"Labayen","sequence":"first","affiliation":[{"name":"Institute for Sustainability & Food Chain Innovation (ISFOOD), Department of Health Sciences, Public University of Navarre , 31006 Pamplona, Navarre , Spain"},{"name":"IdiSNA, Navarra Institute for 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