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Fatty liver disease is a common metabolic abnormality in adolescents with obesity, but remains under-studied in early childhood. To describe hepatic fat deposition in prepubertal children and examine associations with metabolic markers and body composition. Data were from 286 children ages 4-8 years old in the Healthy Start Study, a longitudinal pre-birth cohort in Colorado. Assessments included magnetic resonance imaging to quantify hepatic and abdominal fats, fasting blood draws to measure metabolic markers, and air displacement plet