Clinical correlates of CT imaging-derived phenotypes among lean and overweight patients with hepatic steatosis

Isabel Song, Elizabeth W. Thompson, Anurag Verma, Matthew T. MacLean, Jeffrey Duda, Ameena Elahi, Richard Tran, Pavan Raghupathy, Sophia Swago, Mohamad Hazim, Abhijit Bhattaru, Carolin Schneider, Marijana Vujkovic, Drew A. Torigian, Charles E. Kahn, James C. Gee, Arijitt Borthakur, Colleen M. Kripke, Christopher C. Carson, Rotonya CarrQasim Jehangir, Yi An Ko, Harold Litt, Mark Rosen, David A. Mankoff, Mitchell D. Schnall, Haochang Shou, Julio Chirinos, Scott M. Damrauer, Marina Serper, Jinbo Chen, Daniel J. Rader, Marylyn D. Ritchie, Jo Ellen Weaver, Nawar Naseer, Afiya Poindexter, Khadijah Hu-Sain, Meghan Livingstone, Fred Vadivieso, Stephanie DerOhannessian, Teo Tran, Julia Stephanowski, Monica Zielinski, Ned Haubein, Joseph Dunn, Anurag Verma, Colleen M. Kripke, Marjorie Risman, Renae Judy, Shefali S. Verma, Yuki Bradford, Scott Dudek, Theodore Drivas, Walter R.T. Witschey, Hersh Sagreiya

Research output: Contribution to journalArticlepeer-review


The objective of this study is to define CT imaging derived phenotypes for patients with hepatic steatosis, a common metabolic liver condition, and determine its association with patient data from a medical biobank. There is a need to further characterize hepatic steatosis in lean patients, as its epidemiology may differ from that in overweight patients. A deep learning method determined the spleen-hepatic attenuation difference (SHAD) in Hounsfield Units (HU) on abdominal CT scans as a quantitative measure of hepatic steatosis. The patient cohort was stratified by BMI with a threshold of 25 kg/m2 and hepatic steatosis with threshold SHAD ≥ − 1 HU or liver mean attenuation ≤ 40 HU. Patient characteristics, diagnoses, and laboratory results representing metabolism and liver function were investigated. A phenome-wide association study (PheWAS) was performed for the statistical interaction between SHAD and the binary characteristic LEAN. The cohort contained 8914 patients—lean patients with (N = 278, 3.1%) and without (N = 1867, 20.9%) steatosis, and overweight patients with (N = 1863, 20.9%) and without (N = 4906, 55.0%) steatosis. Among all lean patients, those with steatosis had increased rates of cardiovascular disease (41.7 vs 27.8%), hypertension (86.7 vs 49.8%), and type 2 diabetes mellitus (29.1 vs 15.7%) (all p < 0.0001). Ten phenotypes were significant in the PheWAS, including chronic kidney disease, renal failure, and cardiovascular disease. Hepatic steatosis was found to be associated with cardiovascular, kidney, and metabolic conditions, separate from overweight BMI.

Original languageEnglish
Article number53
JournalScientific Reports
Issue number1
StatePublished - Dec 2024
Externally publishedYes


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