Significance of liver fat loss in chronic liver disease: Usefulness of hepatic proton density fat fraction measurement by magnetic resonance imaging in evaluating malnutrition

Fatty acids are the largest stored energy in the body, and the liver contributes as a central organ in fatty acid metabolism. The hepatic proton density fat fraction (PDFF) measured using magnetic resonance imaging is a noninvasive method to quantify intrahepatic fat content and is used as a substitute for liver biopsy in diagnosing and therapeutically evaluating fatty liver. In this study, we measured the PDFF in 389 patients with chronic liver disease (CLD) and investigated its relationship with malnutrition. The PDFF was significantly associated with the degree of nutritional impairments in controlling nutritional status and the prevalence of sarcopenia, respectively, and liver fat content was decreased in patients with liver cirrhosis, indicating that PDFF is a prognostic factor independent of liver function. In multivariate analysis, body mass index and albumin were determined as risk factors for hepatic fat loss. PDFF may be a powerful marker for predicting malnutrition in CLD.