Kathleen Elizabeth Jacobs MD, Presenter: Nothing to Disclose

Sharon Sudarshan Brouha MD, MPH, Abstract Co-Author: Nothing to Disclose

Richele Bettencourt, Abstract Co-Author: Nothing to Disclose

Elizabeth Barrett-Connor, Abstract Co-Author: Nothing to Disclose

David Sean Ansdell MD, Abstract Co-Author: Nothing to Disclose

Rohit Loomba MD, MSc, Abstract Co-Author: Nothing to Disclose

To investigate the relationship between hepatic steatosis and progression of coronary artery calcium (CAC) as measured by computed tomography (CT) in the elderly.

We conducted a prospective study of 107 participants (62 women, 45 men; mean age 67.2) with no prior history of heart disease. CT measurements of Agatston CAC scores, liver attenuation, spleen attenuation, volume of visceral adipose tissue (VAT), and volume of subcutaneous adipose tissue (SAT) were obtained at baseline and five-year follow up. Hepatic steatosis was defined as liver attenuation:spleen attenuation (L:S) ratio <1.1.

From baseline to five-year follow up, mean CAC score increased from 347.0 to 465.6 (t-test p<0.0001). VAT:SAT ratio also increased (p=0.01) despite stable BMI and correlated strongly with CAC score (r=0.41, p<0.0001). In contrast, L:S ratio increased from 1.19 to 1.33 (p<0.0001) with the proportion of patients with hepatic steatosis decreasing from 34% to 15% (p=0.001). No significant correlation was observed between change in L:S ratio and change in CAC score over the five-year time period.  

Hepatic steatosis as defined by CT L:S ratio was not associated with CAC progression in our elderly study population. Although hepatic steatosis is thought to be a manifestation of metabolic syndrome, a well-known cardiovascular risk factor, our findings suggest age-related changes in liver adiposity independent of visceral adiposity and coronary artery disease.

The association between hepatic steatosis and coronary artery disease is not well known. This is the first prospective study to demonstrate decreased hepatic steatosis despite CAC progression in the elderly.

Jacobs, K, Brouha, S, Bettencourt, R, Barrett-Connor, E, Ansdell, D, Loomba, R, Longitudinal Changes in Hepatic Steatosis and Coronary Artery Calcification in the Elderly: A Prospective Population-based Cohort Study.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14012238.html