Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 25;120(7):1529-1537.
doi: 10.14309/ajg.0000000000003161.

Hepatic Steatosis Estimated by VCTE-Derived CAP Scores Was Associated With Lower Risks of Liver-Related Events and All-Cause Mortality in Patients With Chronic Liver Diseases

Nicole J Kim  1 , Philip Vutien  1 , Joleen A Borgerding  2 , Lauren A Beste  3   4 , Muyi Li  1 , Abbey Barnard-Giustini  1   5 , Kay M Johnson  4   6 , George N Ioannou  1   5
Affiliations

Hepatic Steatosis Estimated by VCTE-Derived CAP Scores Was Associated With Lower Risks of Liver-Related Events and All-Cause Mortality in Patients With Chronic Liver Diseases

Nicole J Kim et al. Am J Gastroenterol. .

Abstract

Introduction: The controlled attenuated parameter (CAP) score derived from vibration-controlled transient elastography (VCTE, i.e., FibroScan) is a well-validated marker of hepatic steatosis. It is unclear whether CAP scores are associated with risks of liver-related outcomes or all-cause mortality.

Methods: In this retrospective cohort study, we identified 7,587 United States veterans (2,689 with cured hepatitis C [hepatitis C virus], 1,523 with alcohol-associated liver disease, and 3,375 with metabolic dysfunction-associated steatotic liver disease [MASLD]) who underwent VCTE between May 2015 and December 2021. We followed patients for new hepatic decompensation, hepatocellular carcinoma, and death from the VCTE date until January 1, 2022. Multivariable Cox-proportional hazards regression was used to assess for the associations between CAP measurements and clinical outcomes, adjusting for age, sex, race/ethnicity, body mass index, Charlson Comorbidity Index, diabetes, liver disease etiology, liver stiffness measurements, and Fibrosis-4 score, and was reported separately by disease etiology and advanced fibrosis status.

Results: Over a median follow-up time of ∼1.9 years, hepatic steatosis (grades 1-3 vs 0) was associated with a lower risk of death (adjusted hazard ratio [aHR] 0.70, 95% CI: 0.57-0.85). Among patients with MASLD, hepatic steatosis was associated with a lower risk of decompensation (aHR 0.54, 95% CI: 0.32-0.90) and death (aHR 0.52, 95% CI: 0.37-0.73). These associations persisted in subgroup analyses of patients with advanced fibrosis and without cirrhosis.

Discussion: Among patients who underwent VCTE in clinical practice, the presence of substantial hepatic steatosis estimated by the CAP score was associated with lower all-cause mortality among all patients and lower risk of decompensation and death among those with MASLD.

Keywords: ALD; HCV; MASLD; outcomes; transient elastography.

PubMed Disclaimer

References

    1. Kaplan DE, Ripoll C, Thiele M, et al. AASLD practice guidance on risk stratification and management of portal hypertension and varices in cirrhosis. Hepatology 2023;79(5):1180–211.
    1. Mak LY, Hui RW, Fung J, et al. Reduced hepatic steatosis is associated with higher risk of hepatocellular carcinoma in chronic hepatitis B infection. Hepatol Int 2021;15(4):901–11.
    1. Vilar-Gomez E, Vuppalanchi R, Gawrieh S, et al. CAP and LSM as determined by VCTE are independent predictors of all-cause mortality in the US adult population. Hepatology 2023;77(4):1241–52.
    1. Cardoso CRL, Villela-Nogueira CA, Leite NC, et al. Prognostic impact of liver fibrosis and steatosis by transient elastography for cardiovascular and mortality outcomes in individuals with nonalcoholic fatty liver disease and type 2 diabetes: the Rio de Janeiro Cohort study. Cardiovasc Diabetol 2021;20(1):193.
    1. Dunn MA, Behari J, Rogal SS, et al. Hepatic steatosis in diabetic patients does not predict adverse liver-related or cardiovascular outcomes. Liver Int 2013;33(10):1575–82.

LinkOut - more resources