Cohen CC, Perng W, Sundaram SS, et al. - Because the fatty liver disease is a common metabolic abnormality in obese adolescents but is understudied in early childhood, researchers set out to describe hepatic fat deposition in prepubertal children and investigate associations with metabolic markers and body composition. The Healthy Start Study, a longitudinal pre-birth cohort in Colorado, included 286 children aged 4 to 8 years old. Assessments involved MRI to quantify hepatic and abdominal fats, fasting blood draws to measure metabolic markers, and air displacement plethysmography to measure body composition (fat mass and fat-free mass). Data reported that the median (IQR) for hepatic fat was 1.65%. While hepatic fat was low in children aged 4 to 8, it was independently linked to estimated insulin sensitivity and showed sex-specific associations with glucose and triglycerides, implying that hepatic fat may be an early indicator of metabolic dysfunction in youth.