Risk factors for hepatic steatosis in adults with cystic fibrosis: Similarities to non-alcoholic fatty liver disease

Table 1 Demographics of our patient sample

Feature	All subjects	Data by hepatic steatosis
		Hepatic steatosis	No steatosis	P value
No. of patients	114	17	97
Male/female	58/56	9/8	49/48	0.854
Median age at time of study (IQR)	29 (24-35)	27	29	0.981
Median BMI (IQR)	20.9 (19.3-24.9)	22.3	20.7	0.010a
Underweight (BMI < 18.5)	19	2	17	0.557
Overweight (BMI > 25)	28	8	20	0.019a
Genotype
ΔF508/ΔF508	57	11	46	0.216
ΔF508/other	44	6	38	0.714
Other	11	0	11	0.140
Unknown	2	0	2
ppFEV1	57 (36-76)	75	53	0.037a
Chronic pseudomonas colonization	80	14	66	0.234
Pancreatic insufficiency	92	15	77	0.394
Replacement dose	2011 (1334-2405)	1897	2012	0.610
Meconium ileus	26	4	22	0.939
CFRD	47	4	43	0.108
Hypertension	5	1	4	0.561
Hyperlipidemia	12	1	11	0.665
Any alcohol use	42	8	34	0.344
On CFTR modulator therapy	29	6	23	0.312

^aP < 0.05. IQR: Interquartile range; BMI: Body mass index; ppFEV1: Percent predicted forced expiratory volume in 1 s; CFRD: Cystic fibrosis related diabetes mellitus; CFTR: Cystic fibrosis transmembrane conductance regulator.

Table 2 Comparison of biomarkers between patients found to have hepatic steatosis and those without steatosis on imaging

Biomarker	Data by hepatic steatosis		P value
	Hepatic steatosis (n = 17, 15%)	No hepatic steatosis (n = 97, 85%)
AST	23 (20-29)	21 (16-26)	0.284
ALT	27 (19-36)	19 (13-32)	0.048a
ALP	103 (75-120)	99 (73-150)	0.793
Platelets	279 (244-311)	270 (207-342)	0.764
Total bilirubin	0.3 (0.3-0.4)	0.4 (0.2-0.5)	0.022a
INR	1 (1-1.1)	1 (1-1.1)	0.350
Albumin	3.7 (3.5-4.2)	4.2 (3.8-4.4)	0.034a
LDL	78.5 (44-89)	63.5 (45-81)	0.424
HDL	36.5 (31-42)	45 (36-56.5)	0.091
Triglycerides	78.5 (65-96)	80.5 (62-114.5)	0.756
Total cholesterol	124.5 (93-152)	133 (103-162.5)	0.819
HbA1c	6.5 (5.8-7.1)	6.1 (5.5-6.7)	0.097

^aP < 0.05. AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; ALT: Alanine aminotransferase; INR: International normalized ratio; LDL: Low-density lipoprotein; HDL: High-density lipoprotein; HbA_1c: Hemoglobin A_1c.

Table 3 Comparison of non-invasive biomarkers of hepatic fibrosis between patients found to have hepatic steatosis and those without steatosis on imaging

Biomarker	Data by hepatic steatosis		P value
	Hepatic steatosis (n = 17, 15%)	No hepatic steatosis (n = 97, 85%)
APRI	0.28 (0.14-0.27)	0.19 (0.12-0.32)	0.579
FIB-4	0.49 (0.35-0.67)	0.57 (0.36-0.82)	0.629
AAR	0.79 (0.65-1.08)	1.00 (0.82-1.33)	0.017a

^aP < 0.05. APRI: Aspartate aminotransferase to platelet ratio index; FIB-4: Fibrosis 4 score; AAR: Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio.