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[Associations of hydration status with metabolic dysfunction-associated steatotic liver disease and parameters of
1Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, China.
Insights
Children
Area of Science:
- Pediatric gastroenterology and hepatology.
- Non-invasive liver assessment techniques.
- Metabolic and cardiovascular risk factors in children.
Context:
- Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly prevalent in children.
- Hydration status is a modifiable factor that may influence liver health.
- Transient elastography offers non-invasive assessment of liver steatosis and fibrosis.
Purpose:
- To investigate the association between hydration status and MASLD in children.
- To examine the relationship between hydration status and liver elastography parameters (steatosis and fibrosis).
- To determine if dehydration is linked to unfavorable liver outcomes in pediatric populations.
Summary:
- Dehydration was prevalent in 76.2% of children at follow-up.
- Dehydrated children showed increased risks of MASLD (RR=1.77), hepatic steatosis (RR=1.28), and hepatic fibrosis (RR=1.65).
- Dehydration was associated with a higher number of unfavorable liver outcomes (RR=1.47).
Impact:
- Findings highlight dehydration as a significant risk factor for pediatric MASLD and liver disease progression.
- Emphasizes the importance of adequate hydration for maintaining liver health in children.
- Suggests hydration status as a potential target for interventions to prevent or manage pediatric liver conditions.
Abstract:
Objective: To explore the association of hydration status with metabolic dysfunction-associated steatotic liver disease (MASLD) and parameters of liver transient elastography in children. Methods: Participants were enrolled from the child cohort conducted to study sensitization, puberty, obesity, and cardiovascular risk (PROC), including 1 643 children surveyed at baseline from October 2018 to June 2019 and 1, 501 children followed up in April 2023. Data on hydration status, MASLD, and liver transient elastography parameters (for 1 499 children) were collected. Hepatic steatosis was defined as ultrasonic attenuation parameter (UAP)≥249 dB/m, and hepatic fibrosis was defined as liver stiffness measurement (LSM)≥8.0 kPa. For children with MASLD, hepatic steatosis or fibrosis were defined as unfavorable liver outcomes. Poisson regression and generalized estimating equations were used to determine the associations of hydration status with MASLD, hepatic steatosis, hepatic fibrosis, and the number of unfavorable liver outcomes when baseline data combined follow-up data. Results: At baseline, 1 643 children aged [M (Q1, Q3)] 6.6 (6.4, 6.8) years, with 828 boys (50.4%) were enrolled. Dehydration was present in 35.0% of children (575/1 643) at baseline and 76.2% (1 144/1 501) of children at follow-up (P<0.001). The incidence of MASLD during follow-up was higher than that at baseline [12.7% (191/1 501) vs 6.9% (113/1 643), P<0.001]. Compared to children with normal hydration, dehydrated children had increased risks of MASLD (RR=1.77, 95%CI: 1.42-2.20), hepatic steatosis (RR=1.28, 95%CI: 1.08-1.52), hepatic fibrosis (RR=1.65, 95%CI: 1.09-2.50), and more unfavorable liver outcomes (RR=1.47, 95%CI: 1.25-1.73) when baseline data combined follow-up data. Conclusion: Children's dehydration status is linked to unfavorable liver outcomes, including MASLD, hepatic steatosis and fibrosis, as assessed by transient elastography.
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