Lymph Node Adiposity and Metabolic Dysfunction-Associated Steatotic Liver Disease

<b>Objective</b>: Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as the most common chronic liver disease, is soon to be the leading indication for liver transplantation; however, the diagnosis may remain occult for decades. There is a need for biomark...

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Main Authors: Jessica M. Rubino, Natalie Yanzi Ring, Krishna Patel, Xiaoqing Xia, Todd A. MacKenzie, Roberta M. diFlorio-Alexander
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/13/1/80
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author Jessica M. Rubino
Natalie Yanzi Ring
Krishna Patel
Xiaoqing Xia
Todd A. MacKenzie
Roberta M. diFlorio-Alexander
author_facet Jessica M. Rubino
Natalie Yanzi Ring
Krishna Patel
Xiaoqing Xia
Todd A. MacKenzie
Roberta M. diFlorio-Alexander
author_sort Jessica M. Rubino
collection DOAJ
description <b>Objective</b>: Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as the most common chronic liver disease, is soon to be the leading indication for liver transplantation; however, the diagnosis may remain occult for decades. There is a need for biomarkers that identify patients at risk for MASLD and patients at risk for disease progression to optimize patient management and outcomes. Lymph node adiposity (LNA) is a novel marker of adiposity identified within axillary lymph nodes on screening mammography. Recent studies have demonstrated a correlation between LNA and cardiometabolic disease and cardiovascular disease risk. This study aimed to investigate the association between MASLD and LNA to evaluate the potential of mammographic LNA to serve as an imaging biomarker of MASLD. <b>Methods</b>: We identified women with pathology-proven MASLD who had a liver biopsy and a screening mammogram within 12 months of the liver biopsy. This resulted in a sample size of 161 women for final analysis that met the inclusion criteria. We evaluated lymph node adiposity through multiple measurements of the largest axillary lymph node visualized on mammography and correlated LNA with MASLD histology. Statistical analysis using univariable and multivariable logistic regression and odds ratios was performed using R version 4.1.0 (2021), the R Foundation for Statistical Computing Platform. <b>Results</b>: We found a significant association between MASLD and mammographic LNA, defined as lymph node (LN) length > 16 mm (<i>p</i> = 0.0004) that remained significant after adjusting for clinical factors, including body mass index (BMI). We additionally found a significant association between LNA and metabolic dysfunction-associated steatohepatitis (MASH), identified via liver biopsy (<i>p</i> = 0.0048). <b>Conclusions</b>: Mammographic lymph node adiposity may serve as a helpful imaging biomarker of MASLD in women who have an elevated risk for the development of MASH.
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spelling doaj-art-97b7a5124b6944bbba9841b841f70bea2025-01-24T13:23:56ZengMDPI AGBiomedicines2227-90592025-01-011318010.3390/biomedicines13010080Lymph Node Adiposity and Metabolic Dysfunction-Associated Steatotic Liver DiseaseJessica M. Rubino0Natalie Yanzi Ring1Krishna Patel2Xiaoqing Xia3Todd A. MacKenzie4Roberta M. diFlorio-Alexander5Radiology Department, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, USAGeisel School of Medicine at Dartmouth, Hanover, NH 03755, USAHartford Healthcare, Midstate Radiology Associates, Hartford, CT 06103, USADepartment of Biomedical Data Science, Dartmouth College, HB 7261, Lebanon, NH 03756, USADepartment of Biomedical Data Science, Dartmouth College, HB 7261, Lebanon, NH 03756, USARadiology Department, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, USA<b>Objective</b>: Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as the most common chronic liver disease, is soon to be the leading indication for liver transplantation; however, the diagnosis may remain occult for decades. There is a need for biomarkers that identify patients at risk for MASLD and patients at risk for disease progression to optimize patient management and outcomes. Lymph node adiposity (LNA) is a novel marker of adiposity identified within axillary lymph nodes on screening mammography. Recent studies have demonstrated a correlation between LNA and cardiometabolic disease and cardiovascular disease risk. This study aimed to investigate the association between MASLD and LNA to evaluate the potential of mammographic LNA to serve as an imaging biomarker of MASLD. <b>Methods</b>: We identified women with pathology-proven MASLD who had a liver biopsy and a screening mammogram within 12 months of the liver biopsy. This resulted in a sample size of 161 women for final analysis that met the inclusion criteria. We evaluated lymph node adiposity through multiple measurements of the largest axillary lymph node visualized on mammography and correlated LNA with MASLD histology. Statistical analysis using univariable and multivariable logistic regression and odds ratios was performed using R version 4.1.0 (2021), the R Foundation for Statistical Computing Platform. <b>Results</b>: We found a significant association between MASLD and mammographic LNA, defined as lymph node (LN) length > 16 mm (<i>p</i> = 0.0004) that remained significant after adjusting for clinical factors, including body mass index (BMI). We additionally found a significant association between LNA and metabolic dysfunction-associated steatohepatitis (MASH), identified via liver biopsy (<i>p</i> = 0.0048). <b>Conclusions</b>: Mammographic lymph node adiposity may serve as a helpful imaging biomarker of MASLD in women who have an elevated risk for the development of MASH.https://www.mdpi.com/2227-9059/13/1/80non-alcoholic fatty liver diseasefatty liversteatohepatitisobesitymetabolic disordersmetabolic dysfunction
spellingShingle Jessica M. Rubino
Natalie Yanzi Ring
Krishna Patel
Xiaoqing Xia
Todd A. MacKenzie
Roberta M. diFlorio-Alexander
Lymph Node Adiposity and Metabolic Dysfunction-Associated Steatotic Liver Disease
Biomedicines
non-alcoholic fatty liver disease
fatty liver
steatohepatitis
obesity
metabolic disorders
metabolic dysfunction
title Lymph Node Adiposity and Metabolic Dysfunction-Associated Steatotic Liver Disease
title_full Lymph Node Adiposity and Metabolic Dysfunction-Associated Steatotic Liver Disease
title_fullStr Lymph Node Adiposity and Metabolic Dysfunction-Associated Steatotic Liver Disease
title_full_unstemmed Lymph Node Adiposity and Metabolic Dysfunction-Associated Steatotic Liver Disease
title_short Lymph Node Adiposity and Metabolic Dysfunction-Associated Steatotic Liver Disease
title_sort lymph node adiposity and metabolic dysfunction associated steatotic liver disease
topic non-alcoholic fatty liver disease
fatty liver
steatohepatitis
obesity
metabolic disorders
metabolic dysfunction
url https://www.mdpi.com/2227-9059/13/1/80
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