1H-MRS spectra were acquired with a 3.0 Tesla MR system (Siemens, Tim Trio, Erlangen, Germany) using a body matrix coil and a spine matrix (Siemens, Erlangen, Germany) as shown previously (14 (link), 15 (link)). Liver spectra were fitted using the AMARES algorithm in the Java-based magnetic resonance user interface (jMRUI) software package (20 (link)). The average of eight spectra was used for liver triglyceride calculation. NAFLD was defined as IHTG ≥5.0% as shown previously in adolescents (3 (link)).