Quantitative Estimation of the Degree of Hepatic Macrovesicular Steatosis in a Disease-free Population: a Single-center Experience in Mainland China

The aim of this study was to derive a simple equation to enable the extent of hepatic macrovesicular steatosis (HMS) to be predicted quantitatively from data obtained noninvasively and hence avoid unnecessary liver biopsies. One hundred sixty-seven potential living liver donors and 45 subjects suspected of having nonalcoholic fatty liver disease (NAFLD) underwent percutaneous liver biopsy to evaluate HMS quantitatively. Their hepatic unenhanced computed tomography (CT) attenuation, body mass index (BMI), and indices of serum lipids were reviewed. Logistic regression analysis was undertaken to screen for independent predictors of HMS. Linear regression analysis was then used to plot the relationship between the severity of histologically confirmed HMS and identified independent predictors of HMS. For potential donors with HMS of severity > or = 5% by histological assessment, the following equation was derived: HMS = 47.7 + 1.48BMI - 1.14CT (R2 = 0.74)The calculated HMS for potential donors with histologically confirmed HMS of severity < 5% seemed to be unreliable (R(2) = = 0.230, P < 0.3). In addition, in subjects suspected of having NAFLD, there was a close agreement between values for histologically confirmed HMS and calculated values for HMS derived from the equation (intraclass correlation coefficient = 0.88). Hepatic CT imaging in conjunction with other noninvasive clinical data may enable the extent of HMS to be accurately predicted with the equation derived from potential donors with appreciable degrees of histologically confirmed HMS.