Association between Non-alcoholic Fatty Liver and Coronary Artery Calcification Using CT Coronary Calcium Score Scan | ||||
| SVU-International Journal of Medical Sciences | ||||
| Volume 8, Issue 2, July 2025, Page 259-269 PDF (497.08 K) | ||||
| Document Type: Original research articles | ||||
| DOI: 10.21608/svuijm.2025.403921.2214 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Lina Tarek Hablas  ; Eman Abdel Sadek Taha Elreweny; Doaa Ashour Taha El Fakharany
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| Department of Radiodiagnosis and Medical Imaging, Faculty of Medicine, Tanta University, Tanta, 31511, Egypt | ||||
| Abstract | ||||
| Background: Non-alcoholic fatty liver disease (NAFLD) and coronary artery disease (CAD) are interrelated conditions linked by shared metabolic risk factors. CT-based coronary artery calcium (CAC) scoring is a valuable tool for cardiovascular risk assessment, but its potential for evaluating hepatic steatosis has not been fully explored. Objectives: To investigate the association between NAFLD and CAC using CT-based coronary artery calcium scans. Patients and methods: A retrospective cross-sectional study was conducted involving 404 adult patients referred to cardiovascular screening or CAD risk evaluation between January 2022 and December 2023. Patients were stratified into two groups based on the presence of coronary artery calcification (CAC vs. non-CAC). Hepatic steatosis was assessed through unenhanced CT attenuation values and liver-to-spleen attenuation ratios. Clinical variables including BMI, diabetes, hypertension, and lipid profile were also evaluated. CAC scores were computed using the Agatston method. Results: Among 404 patients, 236 had detectable CAC. The CAC group exhibited significantly higher BMI (median: 27.5 vs. 25.05 kg/m²; p<0.001) and greater prevalence of metabolic comorbidities. Hepatic attenuation values were significantly lower in the CAC group (median liver HU: 38.5 vs. 52; p<0.001), as was the liver-to-spleen ratio (0.78 vs. 1.03; p<0.001). Strong negative correlations were found between CAC scores and hepatic attenuation (r = -0.623) as well as liver-to-spleen ratio (r = -0.633). BMI was positively correlated with CAC score (r = 0.501; p < 0.001) and negatively correlated with hepatic attenuation (r = -0.761). Logistic regression identified both BMI and CAC score as significant predictors of fatty liver (p < 0.001). Conclusion: This study demonstrates a strong association between coronary artery calcification and hepatic fat accumulation as detected on routine non-contrast CT scans. CT imaging may thus serve a dual role in evaluating both CAD risk and NAFLD, particularly in populations with elevated BMI and metabolic risk profiles. | ||||
| Keywords | ||||
| NAFLD; Coronary Artery Disease; Coronary Artery Calcium Score; CT Imaging; Hepatic Attenuation | ||||
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