Hepatic steatosis linked to lower mortality risk in patients with chronic liver disease

The presence of substantial hepatic steatosis estimated by controlled attenuated parameter (CAP) score among patients who underwent vibration-controlled transient elastography (VCTE) appears to reduce the risk of all-cause mortality and decompensation, particularly in those with metabolic dysfunction-associated steatotic liver disease (MASLD), reports a study.

Hepatic steatosis (grades 1‒3 vs 0) significantly correlated with a lower risk of mortality (adjusted hazard ratio [aHR], 0.70, 95 percent confidence interval [CI], 0.57‒0.85) over a median follow-up of 1.9 years.

In addition, MASLD patients with hepatic steatosis showed a reduced risk of decompensation (aHR, 0.54, 95 percent CI, 0.32‒0.90) and death (aHR, 0.52, 95 percent CI, 0.37‒0.73). Such associations endured in subgroup analyses of patients with advanced fibrosis and without cirrhosis.

A total of 7,587 US veterans, of which 1,523 had alcohol-related liver disease and 3,375 had MASLD, who underwent VCTE between May 2015 and December 2021 were included in this retrospective cohort study. These patients were followed for new hepatic decompensation, hepatocellular carcinoma, and death from the VCTE date through 1 January 2022.

The authors used multivariable Cox proportional hazards regression to explore the relationship between CAP measurements and clinical outcomes. Adjustments were made for age, sex, race/ethnicity, BMI, Charlson Comorbidity Index, diabetes, liver disease aetiology, liver stiffness measurements, and Fibrosis-4 score.