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Aim: To explore the relationships between body composition, indices of hepatic fibrosis, and sonographic evidence of hepatic steatosis in children with overweight and obesity., Methods: One hundred and seventy individuals (age 12.7 ± 3.4 years, 38.2% boys) with overweight/obesity (BMI z-score 2.02 ± 0.54) underwent bioelectrical impedance analysis (fat percentage, truncal-to-total fat ratio, muscle-to-fat ratio [MFR]). Hepatic assessments included ultrasonography to detect liver steatosis, alanine transaminase (ALT), aspartate aminotransferase (AST)/ALT ratio, and nonalcoholic fatty liver disease fibrosis score (NFS). A forward logistic regression model, adjusting for sex, age, and socio-economic position, was conducted., Results: The odds for sonographic hepatic steatosis increased by 3.8-fold for each SD decrease in MFR z-score (OR = 0.263, 95% CI [0.067-1.031], p = 0.05). The strongest correlation among boys was between MFR z-score and AST/ALT ratio (r = 0.530, p < 0.001), whereas the strongest correlation among girls was between fat percentage and NFS (r = 0.503, p < 0.001). Individuals with sonographic hepatic steatosis had higher fat mass (p = 0.003), lower MFR z-score (p = 0.020), greater insulin resistance (p = 0.018), and atherogenic dyslipidemic index (p = 0.037) compared to those without., Conclusions: We identified sex differences in the association between body composition and hepatic fibrosis indices. The relationship between adverse body composition and increased odds of hepatic steatosis underscores the importance of its assessment within this at-risk population., (© 2025 The Author(s). Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Aim: To explore corticosteroid prescription practices and knowledge among paediatricians., Methods: The Paediatricians Corticosteroids Survey, a cross-sectional, web-based survey distributed to Israeli paediatricians between February and July 2018., Results: Three hundred and forty-nine paediatricians (105 general paediatricians, 207 subspecialists and 37 paediatric endocrinologists) participated. Two hundred and three (58.2%) had >10 years of paediatric clinical experience and treated >60 patients/wk on average, 175/318 (55%) prescribed corticosteroids to >10% of their patients. On knowledge items, 11/266 (4.1%) responded 'not sure' when tapering of steroids is required, 22/268 (8.2%) to what 'stress dose' meant and 27/268 (10.1%) when a stress dose is required. Multivariate linear analysis showed higher scores were associated with training in paediatric endocrinology (β = 2.271, P = 0.032); medical practice only in a subspecialty (β = 1.909, P = 0.041) or in both general paediatrics and a subspecialty (β = 2.023, P = 0.014), compared to general paediatrics alone and medical studies in Israel (β = 1.059, P = 0.035). Overall, 96.2% thought continued medical education (CME) sessions would be helpful., Conclusion: Our findings suggest that despite clinical experience with corticosteroid usage, respondents demonstrated gaps in knowledge for potentially life-threatening situations. Corticosteroid-based CME programs are warranted to improve paediatricians' knowledge and patient management., (©2020 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)