Abstract
Rationale: Ectopic fat deposition in the abdomen and in the limb muscles has been reported in patients with COPD. The objective of this study was to document the prevalence and consequences of fatty liver infiltration in patients with COPD in comparison with healthy controls.
Methods: Using chest CT-scans obtained in the ECLIPSE study, we quantified mean liver attenuation. Hepatic steatosis was defined by CT scan criteria (liver density < 48 Hounsfield Unit). The presence of comorbidities, including diabetes, hypertension and gastro-oesophageal reflux was assessed at baseline from the medical history. Univariate model analyses were used to investigate possible relationships between liver attenuation and the inflammatory profile.
Results: 2,047 images at T12-L1 were retrieved from the initial ECLIPSE cohort of 2,118 subjects. Although mean liver density was similar between COPD and controls, hepatic steatosis was more prevalent in patients with COPD patients than in controls (17.5% vs 12.9%, p < 0.05). The prevalence of hepatic steatosis was not related to the severity of airflow limitation as assessed from the GOLD staging system. In patients with COPD, hepatic steatosis was associated the presence of obesity and diabetes but not with other comorbidities. Patients with COPD with hepatic steatosis exhibited higher IL-6, CC-16, CRP and lower SP-D serum levels than those without it. In addition, regression analyses revealed that IL-6 (p<0.0001) and CRP (p<0,0001) serum levels were closely related to liver density.
Conclusion: The prevalence of hepatic steatosis was increased in patients with COPD in comparison to controls. This was associated with worsened inflammatory status and diabetes.
- Copyright ©the authors 2016