Association Between Controlled Attenuation Parameter and Mortality in Patients with Nonviral, Nonautoimmune Chronic Liver Disease.
- 1Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi, Tokyo 173-8610, Japan.
Abstract
Background/Objectives: Controlled attenuation parameter (CAP) is widely used as a noninvasive marker of hepatic steatosis, but its prognostic significance in nonviral chronic liver disease is unclear. We evaluated the association of CAP with all-cause mortality and its relationship with liver stiffness measurement (LSM) and metabolic factors. Methods: We retrospectively analyzed 1040 patients with nonviral chronic liver disease who underwent FibroScan assessment in 2022 and were followed through April 2025. Cox proportional hazards models were used to identify factors associated with all-cause mortality. CAP and body mass index (BMI) were evaluated in separate primary multivariable models, with an additional exploratory model including both variables. Results: During a median follow-up of 2.8 years, 44 deaths occurred. In a multivariable model adjusted for age, sex, serum albumin, and LSM, lower CAP was independently associated with mortality (HR per 10 dB/m increase, 0.93; 95% CI, 0.89-0.98; p = 0.003), together with lower serum albumin and male sex, whereas LSM was not significant. In an exploratory model including both CAP and BMI, the association between CAP and mortality was no longer statistically significant, whereas BMI remained independently associated with mortality. Overall survival differed significantly across CAP quartiles (log-rank p < 0.001), with the lowest CAP quartile showing the poorest survival. Conclusions: Lower CAP values were associated with increased all-cause mortality; however, this association was no longer statistically significant when BMI was included in the exploratory model. Low CAP should therefore not be interpreted as a favorable phenotype without considering body composition and nutritional status. Further studies incorporating direct measures of sarcopenia and frailty are warranted.
Related
- Assessment of hepatic steatosis by controlled attenuation parameter using the M and XL probes: an individual patient data meta-analysis
- Treatment restrictions after acute stroke across nine European countries and their association with 90-day mortality: a post hoc analysis of the PRECIOUS randomised controlled trial.
- Association Between CT‐Based Rectal Stool Attenuation and Activities of Daily Living in Hospitalized Older Adults
- Comparing attenuation parameter and liver stiffness measurement using Hepatus and Fibroscan for the evaluation of steatosis and fibrosis in patients with chronic liver disease: A prospective study
- WFUMB-Recommended Versus Manufacturer-Optimized Protocols for Ultrasound-Guided Attenuation Parameter in Hepatic Steatosis Assessment: A Retrospective Single-Vendor Multicenter Study
BibTeX
@article{totsuka2026association,
title = {{Association Between Controlled Attenuation Parameter and Mortality in Patients with Nonviral, Nonautoimmune Chronic Liver Disease.}},
author = {Mai Totsuka and Ryota Masuzaki and Naoki Matsumoto and Masayuki Honda and Tomohiro Kaneko and Shuhei Arima and Masahiro Ogawa and Hirofumi Kogure},
journal = {Diseases (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/diseases14100371},
url = {https://europepmc.org/article/MED/42929998},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association Between Controlled Attenuation Parameter and Mortality in Patients with Nonviral, Nonautoimmune Chronic Liver Disease.
AU - Mai Totsuka
AU - Ryota Masuzaki
AU - Naoki Matsumoto
AU - Masayuki Honda
AU - Tomohiro Kaneko
AU - Shuhei Arima
AU - Masahiro Ogawa
AU - Hirofumi Kogure
PY - 2026
DA - 2026/10/07
JO - Diseases (Basel, Switzerland)
DO - 10.3390/diseases14100371
UR - https://europepmc.org/article/MED/42929998
AB - Background/Objectives: Controlled attenuation parameter (CAP) is widely used as a noninvasive marker of hepatic steatosis, but its prognostic significance in nonviral chronic liver disease is unclear. We evaluated the association of CAP with all-cause mortality and its relationship with liver stiffness measurement (LSM) and metabolic factors. Methods: We retrospectively analyzed 1040 patients with nonviral chronic liver disease who underwent FibroScan assessment in 2022 and were followed through April 2025. Cox proportional hazards models were used to identify factors associated with all-cause mortality. CAP and body mass index (BMI) were evaluated in separate primary multivariable models, with an additional exploratory model including both variables. Results: During a median follow-up of 2.8 years, 44 deaths occurred. In a multivariable model adjusted for age, sex, serum albumin, and LSM, lower CAP was independently associated with mortality (HR per 10 dB/m increase, 0.93; 95% CI, 0.89-0.98; p = 0.003), together with lower serum albumin and male sex, whereas LSM was not significant. In an exploratory model including both CAP and BMI, the association between CAP and mortality was no longer statistically significant, whereas BMI remained independently associated with mortality. Overall survival differed significantly across CAP quartiles (log-rank p < 0.001), with the lowest CAP quartile showing the poorest survival. Conclusions: Lower CAP values were associated with increased all-cause mortality; however, this association was no longer statistically significant when BMI was included in the exploratory model. Low CAP should therefore not be interpreted as a favorable phenotype without considering body composition and nutritional status. Further studies incorporating direct measures of sarcopenia and frailty are warranted.
SN - 2079-9721
ER -