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Liver glycogen stores via 13C magnetic resonance spectroscopy in healthy children: randomized, controlled study

Horstman, Astrid MH.; Bawden, Stephen J.; Spicer, Abi; Darwish, Noura; Goyer, Amélie; Egli, Léonie; Rupp, Natacha; Minehira, Kaori; Gowland, Penny; Breuillé, Denis; Macdonald, Ian A.; Simpson, Elizabeth J.

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Astrid MH. Horstman

Abi Spicer

Noura Darwish

Amélie Goyer

Léonie Egli

Natacha Rupp

Kaori Minehira

Denis Breuillé

Ian A. Macdonald

Elizabeth J. Simpson


Background: Owing to its role in glucose homeostasis, liver glycogen concentration ([LGly]) can be a marker of altered metabolism seen in disorders that impact the health of children. However, there is a paucity of normative data for this measure in children to allow comparison with patients, and time-course assessment of [LGly] in response to feeding has not been reported. In addition, carbon-13 magnetic resonance spectroscopy (13C-MRS) is used extensively in research to assess liver metabolites in adult health and disease noninvasively, but similar measurements in children are lacking. Objectives: The main objectives were to quantify the depletion of [LGly] after overnight fasting and the subsequent response to feeding. Methods: In a randomly assigned, open-label, incomplete block design study, healthy, normal-weight children (8–12 y) attended 2 evening visits, each separated by ≥5 d and directly followed by a morning visit. An individually tailored, standardized meal was consumed 3-h prior to evening assessments. Participants then remained fasted until the morning visit. [LGly] was assessed once in the fed (20:00) and fasted state (08:00) using 13C-MRS. After the 8:00 assessment, 200 ml of a mixed-macronutrient drink containing 15.5 g (402 kJ) or 31 g carbohydrates (804 kJ), or water only, was consumed, with 13C-MRS measurements then performed hourly for 4 h. Each child was randomly assigned to 2 of 3 drink options across the 2 mornings. Data are expressed as mean (SD). Results: Twenty-four children including females and males (13F:11M) completed the study [9.9 (1.1) y, BMI percentile 45.7 (25.9)]. [LGly] decreased from 377.9 (141.3) to 277.3 (107.4) mmol/L overnight; depletion rate 0.14 (0.15) mmol/L min. Incremental responses of [LGly] to test drinks differed (P < 0.001), with incremental net area under the curve of [LGly] over 4 h being higher for 15.5 g [−67.1 (205.8) mmol/L·240 min; P < 0.01] and 31 g carbohydrates [101.6 (180.9) mmol/L·240 min; P < 0.005] compared with water [−253.1 (231.2) mmol/L·240 min]. Conclusions: After overnight fasting, [LGly] decreased by 22.9 (25.1)%, and [LGly] incremental net area under the curve over 4 h was higher after subsequent consumption of 15.5 g and 31 g carbohydrates, compared to water.


Horstman, A. M., Bawden, S. J., Spicer, A., Darwish, N., Goyer, A., Egli, L., …Simpson, E. J. (2023). Liver glycogen stores via 13C magnetic resonance spectroscopy in healthy children: randomized, controlled study. American Journal of Clinical Nutrition, 117(4), 709-716.

Journal Article Type Article
Acceptance Date Jan 13, 2023
Online Publication Date Jan 20, 2023
Publication Date Apr 1, 2023
Deposit Date Jan 29, 2023
Publicly Available Date Feb 2, 2023
Journal American Journal of Clinical Nutrition
Print ISSN 0002-9165
Electronic ISSN 1938-3207
Publisher Elsevier BV
Peer Reviewed Peer Reviewed
Volume 117
Issue 4
Pages 709-716
Keywords Muscle glycogen concentration, fasting, feeding, carbohydrate metabolism, gastric emptying
Public URL
Publisher URL


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