Abstract
The noninvasive diagnosis of hepatic steatosis is of increasing concern. This study investigated the association of hepatic steatosis determined by non-enhanced CT criteria with clinical parameters in a screening population. Asymptomatic patients who underwent abdominal CT at our healthcare center were retrospectively analyzed (n = 339). Two radiologists measured the attenuation values of the liver parenchyma and spleen using non-enhanced CT images. CT criteria for hepatic steatosis were (a) absolute liver attenuation value <48 Hounsfield units (HU), (b) liver-to-spleen attenuation ratio <0.8, and (c) attenuation difference between the liver and spleen <−10. Body mass index (BMI) and hepatic steatosis index (HSI) were calculated, and laboratory findings were recorded. The association of hepatic steatosis with clinical parameters was assessed using univariate and logistic regression analyses. The presence of hepatic steatosis was significantly associated with the levels of serum fasting glucose and triglycerides, the alanine aminotransferase to aspartate aminotransferase (ALT/AST) ratio, BMI, and HSI values using any of the CT criteria. Logistic regression analysis revealed that the serum fasting glucose level and HSI were significantly associated with hepatic steatosis using criterion (a), while the ALT/AST ratio and HSI were associated with hepatic steatosis using criteria (b) and (c). The presence of hepatic steatosis on non-enhanced CT should be considered to indicate possible clinical profile abnormalities regarding metabolic syndrome.
Highlights
Published: 23 November 2021Nonalcoholic fatty liver disease (NAFLD) is defined as the accumulation of fat, mainly triglycerides, in hepatocytes without evidence of excessive alcohol consumption or other causes [1]
When criterion (a) was applied, hepatic steatosis was present in 110 patients (32.4%, HUliver 55.6 ± 4.3) and was absent in 229 patients (67.6%, HUliver 39.8 ± 8.9)
Using criterion (b), hepatic steatosis was present in 34 patients (10.0%, CTL/S 0.63 ± 0.20)
Summary
Nonalcoholic fatty liver disease (NAFLD) is defined as the accumulation of fat, mainly triglycerides, in hepatocytes without evidence of excessive alcohol consumption or other causes [1]. This includes a wide spectrum of fatty liver diseases, encompassing simple hepatic steatosis, steatohepatitis, fibrosis, and cirrhosis [2]. Ultrasonography provides fair accuracy for detecting moderate to severe hepatic steatosis but shows limited accuracy for detecting a mild degree of the disease [5]. The qualitative assessment and subjective nature of the examination bear the potential limitation of substantial intraobserver and interobserver variability [6].
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