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Peer-reviewedCC BY-NC-NDBMC medical imaging

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

  • Chongwon Pae1,2
  • Minchul Kim3
  • Jung Hoon Kim1,4
  • Inpyeong Hwang5,6
  • Kyu Sung Choi7,8,9
9 affiliations
  1. 1Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
  2. 2Brain Imaging Center, Seoul National University, Seoul, Republic of Korea.
  3. 3Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
  4. 4Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.
  5. 5Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea. [email protected].
  6. 6Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea. [email protected].
  7. 7Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea. [email protected].
  8. 8Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea. [email protected].
  9. 9Healthcare AI Research Institute, Seoul National University Hospital, Seoul, Republic of Korea. [email protected].
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Abstract

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.

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Cite

BibTeXRIS
BibTeX
@article{pae2026regional,
  title = {{Regional brain morphometric correlates of CT-defined metabolic dysfunction-associated steatotic liver disease and hepatic fat burden.}},
  author = {Chongwon Pae and Minchul Kim and Jung Hoon Kim and Inpyeong Hwang and Kyu Sung Choi},
  journal = {BMC medical imaging},
  year = {2026},
  month = aug,
  doi = {10.1186/s12880-026-02624-5},
  url = {https://europepmc.org/article/MED/42968028},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Regional brain morphometric correlates of CT-defined metabolic dysfunction-associated steatotic liver disease and hepatic fat burden.
AU  - Chongwon Pae
AU  - Minchul Kim
AU  - Jung Hoon Kim
AU  - Inpyeong Hwang
AU  - Kyu Sung Choi
PY  - 2026
DA  - 2026/08/04
JO  - BMC medical imaging
DO  - 10.1186/s12880-026-02624-5
UR  - https://europepmc.org/article/MED/42968028
AB  - 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.
SN  - 1471-2342
ER  -