Attenuation imaging for hepatic steatosis in chronic hepatitis B vs metabolic dysfunction-associated steatotic liver disease

Table 1 Patient characteristics, n (%)

Characteristic	Total (n = 249)	CHB group (n = 78)	MASLD group (n = 171)	P value
Male	90 (36.14)	51 (65.38)	39 (22.81)	< 0.001a
Age (years)	33 (28-39)	40 (33-47)	31 (26-35)	< 0.001a
BMI (kg/m2)	33.71 (26.75-38.03)	23.48 (21.65-25.69)	36.33 (33.27-40.81)	< 0.001a
Fasting glucose (mmol/L)	5.50 (5.10-6.40)	5.65 (5.20-6.27)	5.50 (5.10-6.40)	0.457
ALT (U/L)	41 (25-73)	37 (28-79)	43 (22-70)	0.325
AST (U/L)	26 (19-41)	27 (17-43)	29 (22-48)	0.101
ALP (U/L)	79 (67-95)	82 (69-106)	76 (65-93)	0.055
GGT (U/L)	35 (23-61)	31 (19-63)	35 (26-59)	0.199
TG (mmol/L)	1.53 (1.07-2.10)	1.47 (0.98-2.25)	1.55 (1.08-2.04)	0.788
HDL-C (mmol/L)	1.08 (0.93-1.30)	1.05 (0.89-1.26)	1.14 (0.97-1.52)	0.016a
Steatosis grade				< 0.001a
S0	62 (24.90)	45 (57.69)	17 (9.94)
S1	84 (33.73)	16 (20.51)	68 (39.77)
S2	79 (31.73)	15 (19.23)	64 (37.43)
S3	24 (9.64)	2 (2.56)	22 (12.87)
Fibrosis stage				< 0.001a
F0	31 (12.45)	19 (24.36)	12 (7.02)
F1	71 (28.51)	29 (37.18)	42 (24.56)
F2	96 (38.55)	14 (17.95)	82 (47.95)
F3	46 (18.47)	11 (14.10)	35 (20.47)
F4	5 (2.01)	5 (6.41)	0 (0.00)

^aP < 0.05.

CHB: Chronic hepatitis B; MASLD: Metabolic dysfunction-associated steatotic liver disease; BMI: Body mass index; ALT: Alanine aminotransferase; AST: Aspartate transaminase; ALP: Alkaline phosphatase; GGT: Gamma-glutamyl transpeptidase; TG: Triglycerides; HDL-C: High density lipoprotein cholesterol.

Table 2 Diagnostic performance of attenuation coefficient in the detection of hepatic steatosis

Characteristic	AUC	Cutoff value	Sensitivity (%)	Specificity (%)	Positive predictive value (%)	Negative predictive value (%)	Accuracy (%)
CHB
≥ S1	0.918	0.64	90.9	77.8	75	92.1	83.3
≥ S2	0.960	0.77	88.2	98.4	93.7	96.7	96.1
S3	0.987	0.94	100	98.7	66.7	100	98.7
MASLD
≥ S1	0.836	0.79	84.4	82.3	97.7	36.8	84.2
≥ S2	0.774	0.88	80.2	68.2	71.8	77.3	74.2
S3	0.688	0.93	72.7	63.8	22.8	94.1	64.9

CHB: Chronic hepatitis B; MASLD: Metabolic dysfunction-associated steatotic liver disease; AUC: Aera under the curve.

Table 3 Factors associated with attenuation coefficient

Characteristic	Univariate analysis			Multivariate analysis
	Coefficient	95%CI	P value	Coefficient	95%CI	P value
Male gender	0.040	-0.006 to 0.087	0.090
Age	-0.005	-0.007 to -0.003	< 0.001a	0	-0.002 to 0.002	0.770
BMI	0.012	-0.009 to 0.014	< 0.001a	0.006	0.004 to 0.008	< 0.001a
Fasting glucose	0.017	0.006 to 0.027	0.002a	0.004	-0.003 to 0.012	0.250
AST	0	0 to 0	0.060
ALT	0	0 to 0	0.341
ALP	0	-0.001 to 0	0.169
GGT	0	0 to 0	0.946
TG	0.016	0.009 to 0.024	< 0.001a	0.008	0.002 to 0.014	0.008a
HDL-C	-0.201	-0.277 to -0.123	< 0.001a	-0.024	-0.088 to 0.040	0.462
Steatosis grade	0.134	0.116 to 0.151	< 0.001a	0.097	0.077 to 0.116	< 0.001a
Fibrosis stage	0.040	0.018 to 0.063	< 0.001a	-0.003	-0.020 to 0.015	0.769

^aP < 0.05.

CI: Confidence interval; BMI: Body mass index; ALT: Alanine aminotransferase; AST: Aspartate transaminase; ALP: Alkaline phosphatase; GGT: Gamma-glutamyl transpeptidase; TG: Triglycerides; HDL-C: High density lipoprotein cholesterol.

Table 4 Attenuation coefficient values in patients with different fibrosis stages in all patients

	S0	S1	S2	S3	P value
F0 and F1	0.60 (0.56-0.65)	0.79 (0.68-0.86)	0.96 (0.84-1.00)	1.01 (0.98-1.07)	< 0.001a
F2	0.66 (0.57-0.72)	0.85 (0.80-0.97)	0.96 (0.88-1.07)	0.99 (0.92-1.06)	< 0.001a
F3 and F4	0.54 (0.49-0.61)	0.80 (0.71-0.99)	0.90 (0.86-0.94)	0.94 (0.83-1.04)	< 0.001a
P value	0.078	0.057	0.067	0.375

^aP < 0.05.