Hepatic Steatosis Detected by Abdominal Ultrasonography Is Associated With Worse Prognosis in Underweight Patients
Makoto Higashino, Hidehiro Murakami, Yusuke Okujima, Toshihide Shima, Hiroaki Miyaoka, Atsushi Nakazawa, Toru Ishikawa, Masanori Kawaguchi, Fusao Ikeda, Norio Horiike, Takeshi OkanoueABSTRACT
Aim
To investigate the prognostic factors of hepatic steatosis detected using abdominal ultrasonography (AUS). After identifying low body mass index (BMI) as a potential risk factor, we explored the association between ultrasound‐detected hepatic steatosis (UDHS) and long‐term outcomes in underweight patients.
Methods
We retrospectively analyzed 8599 patients who underwent AUS from 2010 to 2015 at six medical centers. Patients with advanced liver disease or viral hepatitis were excluded. In Analysis 1, patients' baseline characteristics were compared between patients with and without UDHS. In Analysis 2, using Cox proportional hazards model, we assessed the risk factors for mortality among patients with UDHS. In Analysis 3, we conducted a propensity score‐matched analysis of patients with BMI < 18.5 to evaluate UDHS impact on survival and causes of death. Alcohol consumption data were unavailable; therefore, etiologic classification was not possible.
Results
Altogether, 2370 were diagnosed with UDHS. Male sex, low BMI, and diabetes mellitus were significantly associated with increased mortality among patients with UDHS. Among patients with BMI < 18.5, those with UDHS had significantly higher mortality rate than those without UDHS (43.8% vs. 14.6%, p = 0.0035). Nonhepatic malignancy were the leading cause of death in this group.
Conclusions
UDHS in underweight patients was associated with worse prognosis in this exploratory matched analysis. This finding may suggest a higher‐risk subgroup and requires confirmation in larger prospective studies.