{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:42:43Z","timestamp":1765888963713,"version":"3.37.3"},"reference-count":32,"publisher":"American Diabetes Association","issue":"9","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>In adults, there is evidence that improvement of metabolic-associated fatty liver disease (MAFLD) depends on the reduction of myosteatosis. In children, in whom the prevalence of MAFLD is alarming, this muscle-liver crosstalk has not been tested. Therefore, we aimed to explore whether the effects of a multicomponent intervention on hepatic fat is mediated by changes in intermuscular abdominal adipose tissue (IMAAT) in children with overweight\/obesity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>A total of 116 children with overweight\/obesity were allocated to a 22-week family-based lifestyle and psychoeducational intervention (control group, n = 57) or the same intervention plus supervised exercise (exercise group, n = 59). Hepatic fat percentage and IMAAT were acquired by MRI at baseline and at the end of the intervention.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Changes in IMAAT explained 20.7% of the improvements in hepatic steatosis (P &amp;lt; 0.05). Only children who meaningfully reduced their IMAAT (i.e., responders) had improved hepatic steatosis at the end of the intervention (within-group analysis: responders \u221220% [P = 0.005] vs. nonresponders \u22121.5% [P = 0.803]). Between-group analysis showed greater reductions in favor of IMAAT responders compared with nonresponders (18.3% vs. 0.6%, P = 0.018), regardless of overall abdominal fat loss.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>The reduction of IMAAT plays a relevant role in the improvement of hepatic steatosis after a multicomponent intervention in children with overweight\/obesity. Indeed, only children who achieved a meaningful reduction in IMAAT at the end of the intervention had a reduced percentage of hepatic fat independent of abdominal fat loss. Our findings suggest that abdominal muscle fat infiltration could be a therapeutic target for the treatment of MAFLD in childhood.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc21-2440","type":"journal-article","created":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T19:08:24Z","timestamp":1661972904000},"page":"1953-1960","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":7,"title":["Effect of a Multicomponent Intervention on Hepatic Steatosis Is Partially Mediated by the Reduction of Intermuscular Abdominal Adipose Tissue in Children With Overweight or Obesity: The EFIGRO Project"],"prefix":"10.2337","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4513-9108","authenticated-orcid":false,"given":"Cristina","family":"Cadenas-Sanchez","sequence":"first","affiliation":[{"name":"1Institute for Innovation & Sustainable Food Chain Development (ISFOOD), Department of Health Sciences, Public 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Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arantxa","family":"Villanueva","sequence":"additional","affiliation":[{"name":"2Healthcare Research Institute of Navarre (IdiSNA), Pamplona, Spain"},{"name":"5Department of Electrical, Electronic and Communications Engineering, Public University of Navarre, Pamplona, Spain"},{"name":"6Smart Cities Institute, Public University of Navarre, Pamplona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Rodr\u00edguez-Vigil","sequence":"additional","affiliation":[{"name":"7Department of Magnetic Resonance Imaging, Osatek, University Hospital of Alava (HUA), Vitoria-Gasteiz, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Medrano","sequence":"additional","affiliation":[{"name":"3Promoting Fitness and Health Through Physical Activity (PROFITH) Research Group, Sport and Health University Research Institute (iMUDS), Faculty of Sport Sciences, Department of Physical and Sports Education, University of Granada, Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maddi","family":"Os\u00e9s","sequence":"additional","affiliation":[{"name":"1Institute for Innovation & Sustainable Food Chain Development (ISFOOD), Department of Health Sciences, Public University of Navarre, Pamplona, Navarre, Spain"},{"name":"2Healthcare Research Institute of Navarre (IdiSNA), Pamplona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco B.","family":"Ortega","sequence":"additional","affiliation":[{"name":"3Promoting Fitness and Health Through Physical Activity (PROFITH) Research Group, Sport and Health University Research Institute (iMUDS), Faculty of Sport Sciences, Department of Physical and Sports Education, University of Granada, Granada, Spain"},{"name":"8Faculty of Sport and Health Sciences, University of Jyv\u00e4skyl\u00e4, Jyv\u00e4skyl\u00e4, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonatan R.","family":"Ruiz","sequence":"additional","affiliation":[{"name":"3Promoting Fitness and Health Through Physical Activity (PROFITH) Research Group, Sport and Health University Research Institute (iMUDS), Faculty of Sport Sciences, Department of Physical and Sports Education, University of Granada, Granada, Spain"},{"name":"9Instituto de Investigaci\u00f3n Biosanitaria (ibs.Granada), Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4334-3287","authenticated-orcid":false,"given":"Idoia","family":"Labayen","sequence":"additional","affiliation":[{"name":"1Institute for Innovation & Sustainable Food Chain Development (ISFOOD), Department of Health Sciences, Public University of Navarre, Pamplona, Navarre, Spain"},{"name":"2Healthcare Research Institute of Navarre (IdiSNA), Pamplona, 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