Abstract | Proton magnetic resonance spectroscopy (1H MRS) offers a non-invasive means to quantify intrahepatocellular (IHCL) lipid content which until recently was only possible using liver biopsy. Non alcoholic fatty liver disease is a spectrum varying from fatty infiltration to cirrhosis. The prevalence of this condition is increasing worldwide and is increasingly being reported in younger populations. Increased IHCL is associated with obesity, particularly intra-abdominal adiposity, insulin resistance and type II diabetes. We have shown that adipose tissue (AT) distribution is altered in the preterm infant at term, with increased intra-abdominal AT. The aim of this study was to establish the feasibility of investigating IHCL deposition in infants using 1H MRS. Whole body MR AT imaging was performed as previously described on a 1.5T Eclipse system. Preterm infants were studied at term and term infants in the first week. Hepatic 1H MR spectra were obtained using a PRESS sequence (TR 1500ms, TE 135ms). We employed one way analysis of variance. The study was approved by the local research ethics committee. To date we have studied 9 infants, 5 preterm (gestational age 29 - 31 weeks) and 4 healthy term infants. These were compared with 5 healthy control adults. Although adults had a significantly increased content of total AT (p=0.008) with an increased ratio of intra-abdominal to subcutaneous AT (p=0.028), the preterm infants had significantly elevated IHCL compared with term infants and adults (Kruskal Wallis, p=0.016). We have demonstrated the feasibility of obtaining hepatic 1H MR spectra for quantification of IHCL in infants. The clinical relevance of increased hepatic lipid in preterm infants is as yet unknown. It may be transient and represent recovery from previous nutrient deprivation. Alternatively persisting increase in IHCL might underlie the observed abnormalities in insulin sensitivity in adolescence in children born preterm. |
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