Liver-Spleen Ratio: Can It Be Used for the Prediction of Coronary Artery Disease?

ABSTRACT

BACKGROUND: Considering that ectopic fat accumulation in various organs, especially the heart and liver, is a cardiometabolic risk factor, the need for easily accessible markers of ectopic fat accumulation is inevitable. The main starting point of the study is based on the hypothesis of predicting cardiovascular disease risk through the link that can be established between the liver-spleen ratio, which is one of the strong indicators of hepa- tosteatosis, and epicardial adipose tissue volume. METHODS: This was a retrospective study. The records of 283 consecutive patients who underwent coronary computed tomography angiography in our Radiology Department were reviewed retrospectively from our hospital's system. All patients' epicardial adipose tissue volume and liver-spleen ratio were calculated using appropriate criteria on non- contrast computed tomography images. Additionally, the Coronary Artery Disease- Reporting and Data System was calculated on contrast computed tomography images. The participating patients were divided into groups according to the liver-spleen ratio and Coronary Artery Disease-Reporting and Data System score. RESULTS: We found that while there was a negative correlation between the liver-spleen ratio and epicardial adipose tissue volume in the hepatosteatosis group, this relationship was not observed in the non-steatosis group. In addition, we observed that the family his- tory of cardiovascular disease and the frequency of cardiovascular disease were higher in the hepatosteatosis group than in the other group, and there was a correlation between cardiovascular disease and the liver-spleen ratio. Also, we found that age and liver- spleen ratio values were found to be independent predictors of coronary artery disease. CONCLUSION: In our study, we found that the frequency of cardiovascular disease was lower in patients with a high liver-spleen ratio. We also demonstrated in the study that the liver-spleen ratio, which indicates a low level of epicardial adipose tissue volume accumulation, is an independent predictor of cardiovascular disease. In addition, the use of liver-spleen ratio, which is more valuable than liver attenuation in predicting hepatic steatosis, may be more useful in evaluating the risk of hepatosteatosis-related cardio- vascular disease.