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. 2024 Jul;44(7):1700-1714.
doi: 10.1111/liv.15920. Epub 2024 Apr 1.

Severe hepatic steatosis promotes increased liver stiffness in the early stages of metabolic dysfunction-associated steatotic liver disease

Takashi Kumada  1 , Hidenori Toyoda  2 , Sadanobu Ogawa  3 , Tatsuya Gotoh  3 , Yasuaki Suzuki  4 , Katsutoshi Sugimoto  5 , Yuichi Yoshida  6 , Hidekatsu Kuroda  7 , Yoshihiro Kamada  8 , Yoshio Sumida  9 , Takanori Ito  10 , Tomoyuki Akita  11 , Junko Tanaka  11
Affiliations

Severe hepatic steatosis promotes increased liver stiffness in the early stages of metabolic dysfunction-associated steatotic liver disease

Takashi Kumada et al. Liver Int. 2024 Jul.

Abstract

Background & aims: The predictors of progression from steatosis to more advanced stages of metabolic dysfunction-associated steatotic liver disease (MASLD) remain unclear. We evaluated the association between the quantity of hepatic steatosis and longitudinal changes in liver stiffness measurements (LSMs) using magnetic resonance elastography (MRE) in patients with MASLD.

Methods: We retrospectively analysed patients with MASLD who underwent at least two serial MRE and magnetic resonance imaging-based proton density fat fraction (MRI-PDFF) examinations at least 1 year apart. Fine-Gray competitive proportional hazard regression was used to identify LSM progression and regression factors.

Results: A total of 471 patients were enrolled. Factors linked to LSM progression were steatosis grade 3 (MRI-PDFF ≥17.1%, adjusted hazard ratio [aHR] 2.597; 95% confidence interval [CI] 1.483-4.547) and albumin-bilirubin grade 2 or 3 (aHR 2.790; 95% CI 1.284-6.091), while the only factor linked to LSM regression was % decrease rate of MRI-PDFF ≥5% (aHR 2.781; 95% CI 1.584-4.883). Steatosis grade 3 correlated with a higher incidence rate of LSM progression than steatosis grade 1 (MRI-PDFF <11.3%) in patients with LSM stage 0 (<2.5 kilopascal [kPa]), and a % annual decrease rate of MRI-PDFF ≥5% correlated with a higher incidence rate of LSM regression than that of MRI-PDFF >-5% and <5% in patients with LSM stage 1 or 2-4 (≥2.5 kPa).

Conclusions: Severe hepatic steatosis was linked to significant LSM progression in patients with MASLD and low LSM (<2.5 kPa).

Keywords: LSM (liver stiffness measurement); MASLD (metabolic dysfunction–associated steatotic liver disease); MRE (magnetic resonance elastography); MRI‐PDFF (magnetic resonance imaging–based proton density fat fraction).

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References

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