Paul Góngora-Chan

Background/Objectives: To derive computed tomography (CT) attenuation thresholds for grading hepatic steatosis and evaluate their agreement with ultrasonography (US) in adults with overweight or obesity and metabolic dysfunction-associated steatotic liver disease (MASLD) from southeastern Mexico. Methods: Adults (≥18 years) with MASLD who underwent both CT and US were included. Hepatic steatosis on CT was defined by liver attenuation < 40 Hounsfield units (HU) or a liver-to-spleen attenuation difference > 10 HU. US steatosis was graded using a three-point echogenicity scale. CT attenuation thresholds were derived in a training dataset (70%) using sequential receiver operating characteristic (ROC) analyses and the Youden index and were subsequently evaluated in an internal hold-out dataset (30%). Histopathological findings were available in a subgroup for additional evaluation. Agreement between CT-predicted and US-based steatosis grades was assessed using Spearman’s rank correlation coefficient (ρ) and quadratic-weighted Cohen’s kappa (κ). Results: In total, 105 participants were included. The training-set ROC analyses identified CT attenuation thresholds of ≤28.15 HU for Grade 3 steatosis (AUC = 0.995), 28.15–35.50 HU for Grade 2 (AUC = 0.983), and >35.50 HU for Grade 1. In the internal hold-out dataset, CT-predicted and US-based steatosis grades showed a strong positive correlation (ρ = 0.946, p < 0.001) and almost perfect agreement (quadratic-weighted κ = 0.940, p < 0.001). Liver biopsy data were available for 16 participants, and CT-predicted steatosis grade was positively associated with histological fat percentage (ρ = 0.595, p = 0.015). Conclusions: The proposed CT attenuation thresholds showed high agreement with US-based steatosis grading, and their association with histopathological fat content provided additional supportive evidence in a subgroup of participants. These findings suggest that CT attenuation may provide a useful quantitative approach to grading hepatic steatosis and could contribute to more consistent steatosis assessment across different healthcare settings.

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is an increasingly prevalent disease closely linked to dietary habits and body composition, particularly reflected in lean mass and markers such as appendicular skeletal muscle mass (ASM). Low ASM can subsequently trigger metabolic abnormalities such as metabolic syndrome (MetS). This study aimed to evaluate the relationships between the diet quality index, ASM, and MetS in individuals with MASLD from the Yucatan Peninsula. Methods: A cross-sectional study was conducted in subjects with a MASLD diagnosis. Diet quality index, anthropometric and biochemical parameters were evaluated. Body composition analysis was utilized to estimate ASM. Correlations between ASM and anthropometric/biochemical parameters were analyzed. Furthermore, comparative analyses were performed between groups stratified by the presence of MetS and low ASM. Results: Fifty subjects were included in the study. Participants exhibited a significantly low diet quality index (57.6 ± 9.78 vs. 100, p < 0.001), alongside a high prevalence of both low ASM and MetS. ASM was positively correlated with BW, WC, and protein mass (p < 0.001), as well as with creatinine and ALT (p < 0.05), and negatively correlated with body fat percentage and TG (p < 0.05). Subjects with low ASM showed significant differences in BW, waist circumference, protein mass, and energy intake compared to those with normal ASM (p < 0.05). Individuals with MetS had higher glucose and blood pressure compared to non-MetS (p < 0.05). Additionally, among patients with MASLD and MetS, those with low ASM exhibited higher glucose and systolic blood pressure compared to those with normal ASM (p < 0.05). Conclusions: Our study demonstrates that adults with MASLD from the Yucatan Peninsula exhibited suboptimal diet quality according to the DQI-I, with a high prevalence of low ASM and MetS. These findings highlight the potential role of the muscle–liver axis in metabolic dysfunction in MASLD.

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by excessive triglyceride accumulation in the liver, the presence of one or more cardiometabolic risk factors, and an absence of harmful alcohol intake. Oxidative stress plays a crucial role in the development and severity of this disease, contributing to an increased cardiovascular risk (CVR). Malondialdehyde (MDA), an oxidative biomarker resulting from lipid peroxidation, is closely associated with metabolic dysfunction. This study aimed to evaluate the role of MDA as a predictor of steatosis severity and CVR. Methodology: An observational cross-sectional study was conducted in a population with MASLD with hepatic steatosis confirmed by ultrasonography and computed tomography. Subjects were classified according to severity of the hepatic steatosis as grade I or grade II-III. Nutritional, anthropometric, and serum biochemical parameters were measured. MDA levels were determined using a spectrophotometric method. The CVR was assessed using waist-to-hip ratio (WHR), triglycerides-glucose (TyG) index, lipid accumulation product (LAP), and atherogenic index of plasma (AIP). Receiver operating characteristic (ROC) curve analysis was performed to identify MDA cut-off value, followed by multivariable logistic regression to assess its association with severity of steatosis adjusted for body fat percentage. Results: A total of 50 patients were included (21 men and 29 women). An MDA cut-off value ≥ 0.13 nmol/mL was associated with higher severity (grade II–III vs. grade I) (OR = 5.0; 95% CI: 1.20–20.0; p = 0.022). Higher WHR values were found in subjects with grade I (p = 0.049), and elevated TyG index values were observed in patients with grade I-III (p = 0.042) both indicating increased CVR. Conclusions: Elevated MDA levels and higher body fat percentage were associated with higher degree of hepatic steatosis and increased CVR in the population from southeastern Mexico.