Diagnostic and Interventional Radiology
Abdominal Imaging - Original Article

Hepatic steatosis: correlations of body mass index, CT fat measurements, and liver density with biopsy results


Department of Radiology, University of Illinois at Chicago, Chicago, Illinois, USA


Department of Radiology, University of Illinois at Chicago, Chicago, IL, USA


Albert Einstein College of Medicine Yeshiva University, Bronx, New York, USA


Departments of Radiology, The Queen Elizabeth Hospital, South Australia, Australia

Diagn Interv Radiol 2012; 18: 282-287
DOI: 10.4261/1305-3825.DIR.4958-11.2
Read: 853 Downloads: 671 Published: 03 September 2019


To assess the relationship between body mass index (BMI), subcutaneous and intra-abdominal fat, liver density, and histopathologic hepatic steatosis.


In this retrospective study, 143 patients (male/female, 67/76; mean age, 50 years) underwent a non-targeted transjugular (n=125) or percutaneous (n=18) liver biopsy between 2006 and 2010. The biopsy indications included chronic liver parenchymal disease staging (n=88), elevated enzymes (n=39), or other reasons (n=16). The BMI and non-contrast liver computed tomography liver density were recorded for each patient. The thicknesses of the anterior, posterior, and posterolateral subcutaneous fat, along with the intra-abdominal fat, were measured. The values were then correlated with histopathologic steatosis.


Of the patients, 47/143 (32%), 39/143 (28%), and 57/143 (40%) were normal weight, overweight, and obese, respectively. Steatosis was present in 13/47 (28%) of normal weight, 18/39 (46%) of overweight, and 38/57 (67%) of obese patients. Significant differences in BMI (26.7 kg/m2 vs. 31.7 kg/ m2 vs. 35.0 kg/m2, P < 0.001), liver density (52.8 HU vs. 54.4 HU vs. 42.0 HU, P < 0.001), anterior subcutaneous (1.8 cm vs. 2.4 cm vs. 2.9 cm, P < 0.001), posterolateral subcutaneous (2.8 cm vs. 3.2 cm vs. 4.4 cm, P < 0.004), posterior subcutaneous (1.9 cm vs. 2.5 cm vs. 3.4 cm, P < 0.001), and intra-abdominal fat thickness (1.1 cm vs. 1.3 cm vs. 1.4 cm, P < 0.013) were identified in patients with different degrees of steatosis (none, minimal to mild, moderate to severe, respectively). BMI (r=0.37, P < 0.001) and the anterior subcutaneous fat (r=0.30, P < 0.001) had a moderate correlation with the presence of liver steatosis. A combination of a BMI ≥32.0 kg/ m2 and an anterior subcutaneous fat thickness ≥2.4 cm had a 40% sensitivity and 90% specificity for the identification of steatosis.


Increase in the anthropomorphic metrics of obesity is associated with an increased frequency of liver steatosis.

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