Highlights
- •LDCT images can provide important information about hepatic steatosis non-invasively and at no additional cost.
- •Individuals with liver attenuation < 40HU on LDCT should be advised of the high likelihood of having excess liver fat.
- •Patients with liver attenuation < 40HU should contact their referring physician or a liver specialist for further work up.
Abstract
Background and aims
To determine the prevalence of moderate-to-severe hepatic steatosis (HS) and associated
risk factors in members of the World Trade Center (WTC) General Responder Cohort (GRC)
who qualify for low-dose non-contrast computed tomography for lung cancer screening
and compare them to non-WTC participants in the same screening program.
Methods
All participants gave written informed consent before participating in this IRB-approved
study. Clinical variables and laboratory values were recorded. Hepatic attenuation
measurement (Hounsfield unit; HU) was measured on low-dose computed tomography (LDCT)
and a threshold attenuation value <40HU indicated moderate-to-severe HS. Bivariate
and multivariable linear and logistic regression analyses were performed. Propensity
scores (PS) were calculated and inverse probability weighting (IPW) was used to adjust
for potential confounders when comparing the WTC with non-WTC participants.
Results
The prevalence of moderate-to-severe HS was 16.2% among 154 WTC participants compared
to 5.3% among 170 non-WTC participants. In WTC members, moderate-to-severe HS was
associated with higher BMI, higher laboratory liver function tests, and former smoking
status. Using PS analysis and IPW to account for potential confounders, the odds ratio
for moderate-to-severe HS was 3.4-fold higher (95% confidence interval: 1.7–6.7) in
the WTC participants compared with non-WTC participants. Moderate-to-severe HS was
also associated with higher BMI and former smoker status.
Conclusion
Prevalence of moderate-to-severe HS was >3-fold higher in the WTC-GRC group than in
other participants.
Keywords
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Article info
Publication history
Published online: December 12, 2019
Accepted:
December 9,
2019
Received in revised form:
November 19,
2019
Received:
July 16,
2019
Footnotes
☆Institution at which the work was performed: Icahn School of Medicine at Mount Sinai, New York NY 10029, United States.
Identification
Copyright
© 2019 Published by Elsevier Inc.
