PREVALENCE OF NON-ALCOHOLIC FATTY LIVER DISEASE IN ADULTS EVALUATED BY UNENHANCED COMPUTED TOMOGRAPHY (CT) SCAN

Background: Non-alcoholic fatty liver disease (NAFLD) is an increasingly prevalent hepatic condition worldwide, closely linked to the rising burden of obesity, metabolic syndrome, and type 2 diabetes. NAFLD encompasses a spectrum from simple steatosis to non-alcoholic steatohepatitis (NASH), with potential progression to cirrhosis and hepatocellular carcinoma. In low- and middle-income countries, early detection is often limited due to resource constraints and lack of awareness. Imaging-based assessments, especially computed tomography (CT), offer a valuable non-invasive method for identifying hepatic steatosis in at-risk populations. Objective: To determine the prevalence of non-alcoholic fatty liver disease in asymptomatic Pakistani adults using unenhanced CT scans. Methods: A retrospective cross-sectional study was conducted on 223 asymptomatic adult patients who underwent unenhanced abdominal CT scans at Liaquat University of Medical & Health Sciences. Patients aged 40–70 years were included. Hepatic and splenic attenuation values were measured using regions of interest on a PACS workstation. Hepatic steatosis was defined by a hepatic attenuation index (HAI) ≤ 5 Hounsfield units. Data were analyzed using SPSS version 22.0. Associations with age, gender, and comorbidities including diabetes, hypertension, atherosclerosis, and ischemic heart disease were assessed using chi-square tests (p ≤ 0.05 considered significant). Results: The mean age was 45.03 ± 15.97 years. Mean liver attenuation was 57.37 ± 7.76 HU and mean spleen attenuation was 52.76 ± 3.09 HU. NAFLD was detected in 41.7% of patients. A significantly higher prevalence was found among males (28.3%) and those aged >40 years (27.4%) (p = 0.021). In patients with diabetes, hypertension, and ischemic heart disease, NAFLD prevalence was 12.1%, 10.8%, and 2.2%, respectively. Conclusion: CT-based imaging revealed a substantial prevalence of NAFLD in asymptomatic adults, particularly among older males. Despite lower associations with cardiometabolic conditions, targeted screening remains essential for timely intervention.