Age-Dependent Association of Hepatic Steatosis with Vertebral Trabecular Attenuation in Asymptomatic Adults
4 affiliations
- 1Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan
- 2Spine Center, Hakodate Central General Hospital, Hakodate 040-8585, Japan
- 3Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
- 4Division of Diabetes and Endocrinology, Department of Medicine, NTT Sapporo Medical Center, Sapporo 060-0061, Japan
Abstract
Background/Objectives: Preserving skeletal health before osteoporosis develops has become an important challenge in preventive medicine. In addition to aging, metabolic dysfunction has emerged as a potential contributor to skeletal deterioration. Hepatic steatosis, a manifestation of systemic metabolic dysfunction, has been associated with impaired bone health; however, whether this relationship differs according to age remains unclear, particularly among asymptomatic adults. This study investigated the age-specific association between hepatic steatosis and CT-derived vertebral trabecular attenuation in adults undergoing voluntary health screening. Methods: This cross-sectional study included 553 asymptomatic Japanese adults (median age, 51 years; range, 20–88 years) who underwent non-contrast trunk CT during voluntary health checkups. Hepatic steatosis was assessed using the liver-to-spleen Hounsfield unit (HU) ratio (L/S ratio), with lower values indicating greater hepatic fat accumulation. Vertebral trabecular attenuation was assessed using the mean L1–L3 HU value. Participants were categorized as younger (≤49 years), middle-aged (50–64 years), or older (≥65 years). Multivariable regression analyses adjusted for demographic, clinical, and lifestyle factors were performed overall and by age group. An additional model assessed whether the association between the L/S ratio and vertebral HU values varied with age. Results: In the overall cohort, a lower L/S ratio was independently associated with lower vertebral HU values (β = 0.088, p = 0.018). In age-stratified analyses, this association was most evident in the younger group (β = 0.169, p = 0.010), but was attenuated in the middle-aged (β = 0.073, p = 0.260) and older groups (β = −0.113, p = 0.355). This age-related attenuation was statistically significant (β = −0.112, p = 0.004). Conclusions: Hepatic steatosis was independently associated with lower CT-derived vertebral trabecular attenuation, with the strongest association observed in adults aged ≤49 years. Although unmeasured factors, including menopausal status, may partly explain the observed age-dependent pattern, these findings suggest that hepatic steatosis may be relevant to skeletal health in younger adults and could help identify individuals who may benefit from early assessment and preventive care.
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BibTeX
@article{koike2026agedependent,
title = {{Age-Dependent Association of Hepatic Steatosis with Vertebral Trabecular Attenuation in Asymptomatic Adults}},
author = {Yoshinao Koike and Tsutomu Endo and Ryo Fujita and Yuichi Hasegawa and Shotaro Fukada and Kiyofumi Komano and Hiroyuki Tachi and Akinobu Nakamura and Yuki Oe and Ken Kadoya and Hideki Sudo and Katsuhisa Yamada and M Alaa Terkawi and Ryota Suzuki and Huohuo Xue and Tomoya Sato and Norimasa Iwasaki},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15218409},
url = {https://www.mdpi.com/2077-0383/15/21/8409},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Age-Dependent Association of Hepatic Steatosis with Vertebral Trabecular Attenuation in Asymptomatic Adults
AU - Yoshinao Koike
AU - Tsutomu Endo
AU - Ryo Fujita
AU - Yuichi Hasegawa
AU - Shotaro Fukada
AU - Kiyofumi Komano
AU - Hiroyuki Tachi
AU - Akinobu Nakamura
AU - Yuki Oe
AU - Ken Kadoya
AU - Hideki Sudo
AU - Katsuhisa Yamada
AU - M Alaa Terkawi
AU - Ryota Suzuki
AU - Huohuo Xue
AU - Tomoya Sato
AU - Norimasa Iwasaki
PY - 2026
DA - 2026/10/28
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218409
UR - https://www.mdpi.com/2077-0383/15/21/8409
AB - Background/Objectives: Preserving skeletal health before osteoporosis develops has become an important challenge in preventive medicine. In addition to aging, metabolic dysfunction has emerged as a potential contributor to skeletal deterioration. Hepatic steatosis, a manifestation of systemic metabolic dysfunction, has been associated with impaired bone health; however, whether this relationship differs according to age remains unclear, particularly among asymptomatic adults. This study investigated the age-specific association between hepatic steatosis and CT-derived vertebral trabecular attenuation in adults undergoing voluntary health screening. Methods: This cross-sectional study included 553 asymptomatic Japanese adults (median age, 51 years; range, 20–88 years) who underwent non-contrast trunk CT during voluntary health checkups. Hepatic steatosis was assessed using the liver-to-spleen Hounsfield unit (HU) ratio (L/S ratio), with lower values indicating greater hepatic fat accumulation. Vertebral trabecular attenuation was assessed using the mean L1–L3 HU value. Participants were categorized as younger (≤49 years), middle-aged (50–64 years), or older (≥65 years). Multivariable regression analyses adjusted for demographic, clinical, and lifestyle factors were performed overall and by age group. An additional model assessed whether the association between the L/S ratio and vertebral HU values varied with age. Results: In the overall cohort, a lower L/S ratio was independently associated with lower vertebral HU values (β = 0.088, p = 0.018). In age-stratified analyses, this association was most evident in the younger group (β = 0.169, p = 0.010), but was attenuated in the middle-aged (β = 0.073, p = 0.260) and older groups (β = −0.113, p = 0.355). This age-related attenuation was statistically significant (β = −0.112, p = 0.004). Conclusions: Hepatic steatosis was independently associated with lower CT-derived vertebral trabecular attenuation, with the strongest association observed in adults aged ≤49 years. Although unmeasured factors, including menopausal status, may partly explain the observed age-dependent pattern, these findings suggest that hepatic steatosis may be relevant to skeletal health in younger adults and could help identify individuals who may benefit from early assessment and preventive care.
SN - 2077-0383
ER -