Kang Min Kyu, Song Jeung Eun, Kweon Young Oh, Tak Won Young, Park Soo Young, Lee Yu Rim, Park Jung Gil
Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea.
Department of Internal Medicine, School of Medicine, Daegu Catholic University, Daegu 42472, Republic of Korea.
Diagnostics (Basel). 2024 Oct 17;14(20):2305. doi: 10.3390/diagnostics14202305.
: The role of body composition parameters in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) with presence and severity of coronary artery calcification (CAC) is still not fully elucidated. We aimed to evaluate the impact of computed tomography (CT)-based body composition parameters in patients with MASLD with CAC severity. : In this multicenter study, 1870 individuals underwent cardiac CT for the detection of CAC as well as ultrasonography for the diagnosis of hepatic steatosis. The presence of CAC was defined by a CAC score threshold of >0, while severe CAC was defined by a threshold of >300. Using the abdominal cross-sectional CT images at the L3 vertebra level, we analyzed the skeletal muscle index, visceral to subcutaneous adipose tissue ratio, and muscle density using the Hounsfield unit. : Of 648 patients with MASLD, the proportions of presence of CAC and severe CAC were 45.2% and 9.9%, respectively. Visceral obesity was not associated with the presence of CAC after adjustment for age, sex, smoking, statin therapy, type 2 diabetes, and advanced fibrosis (adjusted odds ratio (aOR), 1.38; 95% confidence interval (CI), 0.86-2.23; = 0.180). However, visceral obesity was independently associated with severe CAC after adjustment for several metabolic risk factors (aOR, 3.54; 95% CI, 1.25-14.90; = 0.039), and adjustment for atherosclerotic cardiovascular disease risk scores (aOR, 3.74; 95% CI, 1.31-15.79; = 0.032). : Visceral obesity may serve as a novel prognostic CT-based radiological biomarker for patients with MASLD with severe CAC.
身体成分参数在伴有冠状动脉钙化（CAC）的存在及严重程度的代谢功能障碍相关脂肪性肝病（MASLD）患者中的作用仍未完全阐明。我们旨在评估基于计算机断层扫描（CT）的身体成分参数对患有CAC严重程度的MASLD患者的影响。：在这项多中心研究中，1870名个体接受了心脏CT检查以检测CAC以及超声检查以诊断肝脂肪变性。CAC的存在由CAC评分阈值>0定义，而严重CAC由阈值>300定义。使用L3椎体水平的腹部横断面CT图像，我们使用亨氏单位分析了骨骼肌指数、内脏与皮下脂肪组织比率以及肌肉密度。：在648例MASLD患者中，CAC存在和严重CAC的比例分别为45.2%和9.9%。在校正年龄、性别、吸烟、他汀类药物治疗、2型糖尿病和晚期纤维化后，内脏肥胖与CAC的存在无关（校正比值比（aOR），1.38；95%置信区间（CI），0.86 - 2.23；P = 0.180）。然而，在校正多个代谢危险因素后，内脏肥胖与严重CAC独立相关（aOR，3.54；95%CI，1.25 - 14.90；P = 0.039），并且在校正动脉粥样硬化性心血管疾病风险评分后（aOR，3.74；95%CI，1.31 - 15.79；P = 0.032）。：内脏肥胖可能作为患有严重CAC的MASLD患者基于CT的一种新的预后放射生物标志物。
