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Background <p>Hepatic steatosis is the defining imaging feature of metabolic dysfunction-associated steatotic liver disease (MASLD) and is detected on abdominal CT. Whether CT-defined MASLD and hepatic fat burden are associated with brain morphometric variation beyond cardiometabolic and CT-derived body composition measures remains unclear. We assessed these associations using brain morphometry.</p> Methods <p>This retrospective cross-sectional study included adults who underwent dual-energy CT with virtual noncontrast images and brain MRI as part of a health-screening program (January 2019 to December 2024). Hepatic steatosis was defined by the liver-to-spleen attenuation ratio on CT, and MASLD by CT-detected steatosis plus at least one cardiometabolic risk factor. Eighty-eight prespecified brain morphometric outcomes, including total cortical volume, regional cortical thickness, and subcortical volumes, were evaluated using age- and sex-adjusted analysis of covariance, two-slope generalized linear modeling anchored at the CT steatosis cutoff and prespecified multivariable generalized linear models. FDR correction was applied across the 88 outcomes within each coefficient family.</p> Results <p>The final cohort comprised 2,689 participants; 775 met the CT steatosis cutoff, and all fulfilled the MASLD cardiometabolic criteria. In the two-slope analysis, four above-cutoff slopes were nominally significant but none survived FDR correction, whereas one below-cutoff association with total cortical volume remained significant. After FDR correction, four HbA1c and four skeletal muscle attenuation associations remained significant; no triglyceride, systolic blood pressure, or abdominal visceral fat attenuation association survived correction.</p> Conclusions <p>CT-defined MASLD showed limited regional morphometric differences, whereas the above-cutoff hepatic fat burden findings did not survive FDR correction. These findings support evaluating CT-detected steatosis within a broader cardiometabolic and body-composition context, although longitudinal studies are needed to clarify temporality and clinical significance.</p>

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Regional brain morphometric correlates of CT-defined metabolic dysfunction-associated steatotic liver disease and hepatic fat burden

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月4日

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  • Chongwon Pae,
  • Minchul Kim,
  • Jung Hoon Kim,
  • Inpyeong Hwang,
  • Kyu Sung Choi

摘要

Background

Hepatic steatosis is the defining imaging feature of metabolic dysfunction-associated steatotic liver disease (MASLD) and is detected on abdominal CT. Whether CT-defined MASLD and hepatic fat burden are associated with brain morphometric variation beyond cardiometabolic and CT-derived body composition measures remains unclear. We assessed these associations using brain morphometry.

Methods

This retrospective cross-sectional study included adults who underwent dual-energy CT with virtual noncontrast images and brain MRI as part of a health-screening program (January 2019 to December 2024). Hepatic steatosis was defined by the liver-to-spleen attenuation ratio on CT, and MASLD by CT-detected steatosis plus at least one cardiometabolic risk factor. Eighty-eight prespecified brain morphometric outcomes, including total cortical volume, regional cortical thickness, and subcortical volumes, were evaluated using age- and sex-adjusted analysis of covariance, two-slope generalized linear modeling anchored at the CT steatosis cutoff and prespecified multivariable generalized linear models. FDR correction was applied across the 88 outcomes within each coefficient family.

Results

The final cohort comprised 2,689 participants; 775 met the CT steatosis cutoff, and all fulfilled the MASLD cardiometabolic criteria. In the two-slope analysis, four above-cutoff slopes were nominally significant but none survived FDR correction, whereas one below-cutoff association with total cortical volume remained significant. After FDR correction, four HbA1c and four skeletal muscle attenuation associations remained significant; no triglyceride, systolic blood pressure, or abdominal visceral fat attenuation association survived correction.

Conclusions

CT-defined MASLD showed limited regional morphometric differences, whereas the above-cutoff hepatic fat burden findings did not survive FDR correction. These findings support evaluating CT-detected steatosis within a broader cardiometabolic and body-composition context, although longitudinal studies are needed to clarify temporality and clinical significance.