Comprehensive assessment of association between abdominal fat depot, hepatic steatosis, and inflammatory serum biomarkers in patients with non-alcoholic fatty liver disease

ntroduction. Non-alcoholic fatty liver disease, being a hepatic manifestation of metabolic syndrome, develops due to the overload of hepatocytes with lipids and metabolic-inflammatory disturbances. These alterations can be quantitatively assessed using unenhanced computed tomography with semi-automatic segmentation of abdominal fat depots and evaluation of hepatic steatosis. Aim. This study was to evaluate the association of quantitative computed tomography parameters of abdominal fat and hepatic steatosis with biochemical markers, inflammatory markers, and the adipokine profile in patients with non-alcoholic fatty liver disease and in healthy individuals. Materials and Methods. The study included 175 patients divided into two groups: The study group with non-alcoholic fatty liver disease (n=95) and the control group without any signs of hepatic steatosis according to computed tomography and laboratory tests (n=80). Unenhanced abdominal computed tomography was performed with the semi-automatic calculation of visceral adipose tissue volume and single-slice scanning, and hepatic steatosis was assessed using liver density and the liver- to-spleen density ratio index. Laboratory testing included measuring the levels of aspartate aminotransferase, alanine aminotransferase, bilirubin, cholesterol, and bile acids in a subset of patients (n=25 per group), with additional analysis of C-reactive protein, tumor necrosis factor alpha, interleukins 1, 6, and 10, leptin, adiponectin, and the leptin/adiponectin ratio. Results and Discussion. Obesity was significantly more prevalent in patients with non-alcoholic fatty liver disease than in the control group (61% vs. 29%). The mean volume and area of visceral adipose tissue were significantly higher in the study group, i.e., 4,217±134 ml and 175±14 cm² versus 2,803±251 ml and 115±11 cm², respectively (p<0.001). Patients in the study group also demonstrated elevated levels of aspartate aminotransferase, alanine aminotransferase, bilirubin, and cholesterol, as well as the decreased liver density (42.3±2.7 vs. 63.7±3.8 Hounsfield units; p<0.001). In the subset of patients, there were the increased leptin, leptin/adiponectin ratio, and C-reactive protein levels reflecting metabolic and inflammatory imbalance associated with visceral obesity. Conclusions. The integration of computed tomography metrics and serum biomarkers provides a non-invasive, informative assessment of the non-alcoholic fatty liver disease phenotype. This approach can be used for stratifying clinical risk, monitoring disease progression, and optimizing individualized therapeutic strategies.

Hali tarjima qilinmagan