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Abstract

This retrospective, cross-sectional study aimed to evaluate the predictive factors of moderate/severe hepatic steatosis diagnosed by vibration-controlled transient elastography (VCTE). It included 158 adult patients with suspected non-alcoholic fatty liver disease (NAFLD) evaluated by VCTE in an outpatient setting of a community-based teaching hospital. Patients with significant alcohol consumption, oral contraceptive use, hepatitis B disease, autoimmune hepatitis, and primary biliary cirrhosis were excluded. Steatosis was categorized as S0-S1 (mild) and S2-S3 (moderate/severe) based on the controlled attenuation parameter (CAP) score. Results demonstrated the mean values of BMI (p=0.001), kiloPascals [kPa] (fibrosis) raw score (p=0.009), obesity (p=0.001), diabetes mellitus [DM] (p=0.014), and comorbidities status [chronic hepatitis C(HCV), DM, obesity, HCV+DM] (p=0.028) were significantly different between the two arms of the study viz. S0-S1 (mild) and S2-S3 (moderate/severe). A multinomial logistic regression analysis of the comorbidities associated with hepatic steatosis revealed a good level of prediction (R2-0.584) for hepatic steatosis. Of all the variables analyzed, obesity was the most impactful variable. Furthermore, the -2 log-likelihood of the regressed model in patients with HCV and hepatic steatosis did not show a significant correlation when adjusted for obesity. Obesity had a significant independent association with steatosis (chi-square value=52, df=12). Interestingly, DM independently predicted a weak association with steatosis (chi-square value=0.825, df= 3). In conclusion, our study demonstrates that hepatic steatosis is independently associated with metabolic parameters like obesity and DM. Management of these risk factors in patients with HCV may be vital to reducing the risk of steatosis and progression to fibrosis.

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