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Pediatrics

Early childhood adiposity, lifestyle and gut microbiome are linked to steatotic liver disease development in adolescents

International Journal of Obesity volume 49, pages 1056–1065 (2025)Cite this article

Subjects

Abstract

Background/Objectives

To examine the relationship between early childhood adiposity, adolescent lifestyles, gut microbiota and steatotic liver disease (SLD) development in adolescents using data from a prospective, longitudinal cohort study.

Methods

We included 69 adolescents (14–17 years old) with SLD and 69 adolescents without SLD, matched for BMI-z scores, sex, and age, from the 13-year longitudinal cohort the “Growth and Obesity Cohort Study”. Anthropometric data between the ages of 4 and 17 and lifestyle parameters (including diet and physical activity) at 14–17 years old were evaluated. Fecal samples were collected and microbiome composition and function were assessed using 16S ribosomal RNA amplicon sequencing.

Results

Principal component analysis demonstrated dietary intake factors and childhood adiposity factors expanding the distribution variation between case and control groups, respectively. Lower odds of developing SLD during adolescence was associated with higher levels of daily fiber intake during adolescence (adjusted odds ratio = 0.91) and lower childhood adiposity (triceps skinfold at 5 years of age, suprailiac skinfold at 8 and 11 years of age, and waist-to-hip ratio at age 5–9 years). SLD was associated with a lower abundance of specific microbial species, such as Bacteroides vulgatus, which was higher in the control group compared to the case group (control/case abundance ratio = 18.71). B. vulgatus abundance also positively correlated with dietary fiber intake and inversely correlated with childhood adiposity.

Conclusions

Adiposity in early childhood and a low dietary fiber intake may contribute to the pathogenesis of SLD during adolescence, possibly through alterations to the intestinal microbiome; these findings could inform early disease markers and targets for intervention.

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Fig. 1
Fig. 2: Microbiome composition differences between SLD and Non-SLD adolescents (n = 66).
Fig. 3: Childhood adiposity trajectories are associated with SLD in adolescents (n = 138).
Fig. 4: Early adiposity and dietary fiber intake are correlated with the SLD-associated gut microbiota.

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Data availability

All data generated or analyzed during this study are included in this published article (and its supplementary information files).

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Funding

This project is funded by FONDECYT 1161456 and 1200839. CC is funded by Young Scientists Fund of the National Natural Science Foundation of China (82103953) and Fundamental Research Funds for the Central Universities (20720220060). ZZ is funded by the Natural Science Foundation of Fujian Province (2022J01332).

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Authors and Affiliations

  1. State Key Laboratory of Vaccines for Infectious Diseases, School of Public Health, Xiamen University, Xiamen, Fujian, China

    Chenxi Cai

  2. College of Ocean Food and Biological Engineering, Jimei University, Xiamen, Fujian, China

    Zhengxiao Zhang

  3. Department of Pediatric Gastroenterology and Nutrition, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

    Gigliola Alberti & Juan Cristóbal Gana

  4. Instituto de Nutrición y Tecnología de los Alimentos, INTA, Universidad de Chile, Santiago, Chile

    Ana Pereira

  5. Radiology Department. School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

    Florencia De Barbieri & Cristián García

  6. Division of Pediatric Gastroenterology, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada

    Eytan Wine

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  1. Chenxi Cai
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  2. Zhengxiao Zhang
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  3. Gigliola Alberti
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  4. Ana Pereira
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  5. Florencia De Barbieri
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  6. Cristián García
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  7. Eytan Wine
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  8. Juan Cristóbal Gana
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Contributions

EW and JCG designed the study. AP, GA and JCG performed clinical studies. CC and ZZ analyzed and interpreted data. CC drafted the manuscript. ZZ, EW, and JCG critical revision of the manuscript for important intellectual content. FDB and CG performed and analyzed clinical data. GA analyzed nutricional data. All authors revised and approved the manuscript.

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Correspondence to Eytan Wine or Juan Cristóbal Gana.

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Cai, C., Zhang, Z., Alberti, G. et al. Early childhood adiposity, lifestyle and gut microbiome are linked to steatotic liver disease development in adolescents. Int J Obes 49, 1056–1065 (2025). https://doi.org/10.1038/s41366-025-01737-1

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