Cadenas-Sánchez, CristinaIdoate, FernandoCabeza Laguna, RafaelVillanueva Larre, ArantxaRodríguez Vigil, BeatrizMedrano Echeverría, MaríaOsés Recalde, MaddiOrtega, Francisco B.Ruiz, Jonatan R.Labayen Goñi, Idoia2023-01-272023-01-272022Cristina Cadenas-Sanchez, Fernando Idoate, Rafael Cabeza, Arantxa Villanueva, Beatriz Rodríguez-Vigil, María Medrano, Maddi Osés, Francisco B. Ortega, Jonatan R. Ruiz, Idoia Labayen; 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. Diabetes Care 1 September 2022; 45 (9): 1953–1960. https://doi.org/10.2337/dc21-24400149-599210.2337/dc21-2440https://academica-e.unavarra.es/handle/2454/44618OBJECTIVE: 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. RESEARCH DESIGN AND METHODS: 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. RESULTS: Changes in IMAAT explained 20.7% of the improvements in hepatic steatosis (P < 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 -20% [P = 0.005] vs. nonresponders -1.5% [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. CONCLUSIONS: 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.application/pdfeng© 2022 by the American Diabetes AssociationHepatic steatosisOverweight childrenObese childrenIntermuscular abdominal adipose tissue (IMAAT)Metabolic-associated fatty liver disease (MAFLD)info:eu-repo/semantics/article2023-01-26info:eu-repo/semantics/openAccess