# Ultrasound assessment of hepatomegaly and metabolically-associated fatty liver disease among a sample of children: a pilot project

## TL;DR

This study explores how obesity in children is linked to liver enlargement and fatty liver disease using ultrasound, showing that these conditions are common in overweight children.

## Contribution

The study introduces ultrasound as a tool to assess liver size and texture in children, revealing early signs of MAFLD and hepatomegaly in overweight populations.

## Key findings

- Obese children had significantly larger right liver lobes and higher waist circumference compared to healthy-weight children.
- Unhealthy weight children showed higher rates of hepatomegaly and fat infiltration in liver texture.
- Liver changes related to obesity appear to begin early in life, highlighting the need for early intervention.

## Abstract

Obesity in children is a global health crisis, with 46% of children in Puerto Rico classified as overweight or obese based on Body Mass Index. This condition is linked to serious comorbidities, including early-onset type 2 diabetes, hypertension, and Metabolic-Associated Fatty Liver Disease (MAFLD), the most common liver disease in U.S. children. This study examines the relationship between body weight, liver size, and texture in children from Puerto Rico.

A craniocaudal right liver lobe (RLL) measurement was performed using a panoramic ultrasound image. RLL length and liver texture were assessed based on fat infiltration. BMI was calculated to classify participants into healthy and unhealthy weight groups, and waist circumference (WC) was compared. Statistical analyses, including Shapiro–Wilk, Student's t-tests, ANOVA, and post hoc Tukey HSD, were conducted with significance at p ≤ 0.05.

Forty-three children aged 7–19 years were recruited. Significant differences were observed in liver size and texture between healthy and unhealthy weight groups: RLL length (p = 0.003), WC (p < 0.001), and BMI (p < 0.001). Obese children had significantly larger RLL and WC than healthy-weight group (p = 0.02; p < 0.001). More children in unhealthy weight group exhibited hepatomegaly (n = 12) and fat infiltration (n = 15).

The findings indicate that large liver and MAFLD are common among children with overweight and obesity, suggesting liver changes related to obesity begin early in life. Strategies to maintain a healthy weight in children are essential to reduce the risk of chronic diseases and potential disabilities in adulthood.