Influence of age, body mass index and gender on sonographic indicators of the liver in patients with metabolic dysfunction-associated steatotic liver disease

Abstract

Background. The incidence of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing along with the increasing prevalence of obesity. There are close relationships between these two pathologies due to the functioning of adipose tissue as an endocrine organ with a complex influence on various metabolic processes. It is known that premenopausal women are less prone to fatty liver disease than men. The aim was to study the influence of gender, body mass index (BMI) and age on sonographic indicators and the degree of liver steatosis in patients with metabolic dysfunction-associated steatotic liver disease. Materials and methods. Ninety-two patients with MASLD were included in the study, 48 women and 44 men. Inclusion criterion was metabolic dysfunction-associated steatotic liver disease, exclusion criteria were any non-metabolic factors of chronic diffuse liver disease. Patients were divided into groups by gender and age. Women were divided by age according to the presence and absence of menopause, men were divided into groups below and above 45 years — the conventional age of the beginning of the decline in gonadotropic function. The analysis of structural changes of the liver, namely the assessment of the size, contours, structure, echogenicity, and visualization of blood vessels in the B-mode was carried out with the help of ultrasound examination on Toshiba Xario 660 (Japan). The degree of steatosis was assessed by the controlled attenuation parameter. Results. In men, the right, left and caudate liver lobes were significantly larger (p < 0.05) than in women, which is due to the higher weight of men in the absence of a difference in the BMI. There was no significant difference between men and women in degree of steatosis (p > 0.05). A moderate positive correlation (r = 0.63) was found between BMI and the controlled attenuation parameter; in women, there was no connection between these indicators. Analysis of correlations in women of different ages, divided by the presence of menopause, found that before menopause, there was no dependence of steatosis indicators on BMI, while with the onset of menopause, the coefficient of correlation between these indicators was 0.39 (р < 0.02). Conclusions. No significant difference was found between the frequency of various degrees of steatosis in MASLD according to the controlled attenuation parameter in men and women. There was a dependence of the severity of liver steatosis on the BMI in men, the dependence of steatosis on the body mass index in women was manifested starting from the menopause period, which suggests the protective role of female sex hormones.