Adiposity is an established risk factor for pediatric nonalcoholic fatty liver disease (NAFLD) , but little is known about the influence of body composition changes earlier in life on future NAFLD risk. Here, we examined associations of body composition trajectories from birth to early childhood with hepatic fat (HF) in early childhood in the Colorado Healthy Start cohort. Fat-free mass index (FFMI) , fat mass index (FMI) , and percent fat mass (%FM) were assessed at birth and/or ∼5 yrs in 1,235 children by air displacement plethysmography. At ∼5 yrs, HF was assessed by magnetic resonance imaging in a sub-sample of 285 children. We used a two-stage modeling approach: first, FFMI, FMI, and %FM trajectories were estimated using mixed models with random intercepts and slopes; second, associations of participant-specific deviations with HF were assessed by linear regression adjusted for confounders. As shown in Table 1, random intercepts for FFMI, FMI, and %FM at birth were all inversely associated with HF in early childhood; whereas %FM slope (i.e., velocity) from birth to ∼5 years was associated with higher HF. These findings suggest that smaller weight at birth, followed by greater gains in %FM are associated with higher HF in early childhood. This supports an influence of early life body composition patterns on HF susceptibility and the importance of perinatal strategies aiming to promote healthy adiposity in infancy/childhood.


C.C. Cohen: None. S.P. Gilley: None. W. Perng: None. K.A. Sauder: None. K. Shankar: None. D.H. Glueck: None. D. Dabelea: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at