Clinical correlates of CT imaging-derived phenotypes among lean and overweight patients with hepatic steatosis.
Clinical correlates of CT imaging-derived phenotypes among lean and overweight patients with hepatic steatosis.
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DOI：
10.1038/s41598-023-49470-x
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发表时间：
2024-01-02
影响因子：
4.6
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中科院分区：
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本研究的目的是定义肝脂肪变性（一种常见的代谢性肝病）患者的CT成像衍生表型，并确定其与医学生物库中患者数据的相关性。有必要进一步描述瘦型患者的肝脂肪变性，因为其流行病学可能与超重患者不同。一种深度学习方法确定了腹部CT扫描上的Hounsfield单位（HU）中的脾-肝衰减差（SHAD），作为肝脏脂肪变性的定量测量。患者队列按BMI（阈值为25 kg/m2）和肝脏脂肪变性（阈值SHAD ≥ − 1 HU或肝脏平均衰减≤ 40 HU）分层。研究了患者特征、诊断和代表代谢和肝功能的实验室结果。对SHAD和二元特征LEAN之间的统计学相互作用进行了全表型关联研究（PheWAS）。该队列包含8914例患者-伴（N = 278，3.1%）和不伴（N = 1867，20.9%）脂肪变性的消瘦患者，以及伴（N = 1863，20.9%）和不伴（N = 4906，55.0%）脂肪变性的超重患者。在所有瘦型患者中，脂肪变性患者的心血管疾病（41.7% vs 27.8%）、高血压（86.7% vs 49.8%）和2型糖尿病（29.1% vs 15.7%）的发病率增加（均p < 0.0001）。在PheWAS中有10种表型是显著的，包括慢性肾脏疾病、肾衰竭和心血管疾病。肝脏脂肪变性被发现与心血管、肾脏和代谢疾病相关，与超重的BMI无关。
The objective of this study is to define CT imaging derived phenotypes for patients with hepatic steatosis, a common metabolic liver condition, and determine its association with patient data from a medical biobank. There is a need to further characterize hepatic steatosis in lean patients, as its epidemiology may differ from that in overweight patients. A deep learning method determined the spleen-hepatic attenuation difference (SHAD) in Hounsfield Units (HU) on abdominal CT scans as a quantitative measure of hepatic steatosis. The patient cohort was stratified by BMI with a threshold of 25 kg/m2 and hepatic steatosis with threshold SHAD ≥ − 1 HU or liver mean attenuation ≤ 40 HU. Patient characteristics, diagnoses, and laboratory results representing metabolism and liver function were investigated. A phenome-wide association study (PheWAS) was performed for the statistical interaction between SHAD and the binary characteristic LEAN. The cohort contained 8914 patients—lean patients with (N = 278, 3.1%) and without (N = 1867, 20.9%) steatosis, and overweight patients with (N = 1863, 20.9%) and without (N = 4906, 55.0%) steatosis. Among all lean patients, those with steatosis had increased rates of cardiovascular disease (41.7 vs 27.8%), hypertension (86.7 vs 49.8%), and type 2 diabetes mellitus (29.1 vs 15.7%) (all p < 0.0001). Ten phenotypes were significant in the PheWAS, including chronic kidney disease, renal failure, and cardiovascular disease. Hepatic steatosis was found to be associated with cardiovascular, kidney, and metabolic conditions, separate from overweight BMI.
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