Correlation between computed tomography adapted leaman score and computed tomography liver and spleen attenuation parameters for non-alcoholic fatty liver disease as well as respective inflammatory mediators

Abstract

Metabolic syndrome is a primary driver of vascular inflammation, plaque development, and atherosclerotic disease. The Computed Tomography-adapted Leaman Score (CT-LeSc) has been shown to be an independent predictor of cardiac events in coronary artery disease (CAD) patients but has never been studied for broader applicability. Non-alcoholic fatty liver disease (NAFLD) is associated with similar systemic inflammatory processes as CAD, and its presence as assessed by Computed Tomography Liver and Spleen Attenuation (CT-LSA) may impact on the extension of the CT-LeSc. The purpose of this study was to investigate the association between the CT-LeSc and NAFLD and to characterize and compare the inflammatory processes of each disease state. This was an exploratory study in which patients with known multivessel CAD who were scheduled to undergo percutaneous coronary intervention were included. CT-LeSc were graded on pre-existing criteria by two independent CoreLab analysts. CT-LSA parameters analyzed included the liver absolute attenuation value, liver and spleen attenuation difference and liver-to-spleen attenuation ratio and were scored by two independent CoreLab analysts as well. Inflammatory mediator analysis included routine laboratory draws for a variety of known signal molecules. The overall liver absolute attenuation value did not correlate significantly with the CT-LeSc, but the subgroup 50 to 65 HU showed moderately negative correlation (R = - 0.629; p = 0.008). The overall liver and spleen attenuation difference did not correlate significantly with the CT-LeSc, but the subgroup 1 to 18 HU showed moderately positive correlation (R = 0.513; p = 0.017). The overall and subgroup liver-to-spleen attenuation ratio did not correlate with the CT-LeSc. The eosinophil and leukocyte ratio showed weakly negative correlation with the overall CT-LeSc (R = - 0.4602; p = 0.008), and VCAM-1 showed moderately negative correlation with CT-LeSc < 16.0 (R = - 0.5678; p = 0.022). Some CT-LSA parameters correlate with high risk CT-LeSc and may both provide complementary information for cardiovascular risk stratification. The significant metrics of liver absolute attenuation value and liver and spleen attenuation difference can be quickly completed in the clinical setting and may support a suspicion of CAD.