Incidence and ultrasonographic patterns of hepatic steatosis in the elderly

Summary ospective ultrasonographic study was conducted to assess the incidence of hepatic steatosis in subjects in the age range 18–92 years, to evaluate the prevalence of hepatic steatosis in different age groups (Group A: age range 65–92 years; Group B: age range 18–64 years and to show the related ultrasonographic patterns (diffuse homogeneous, ultrasound attenuation, skip areas, skip areas and ultrasound attenuation, focal or irregular). The occurrence of hepatic steatosis (24.8 % in the whole study population) showed a statistically significant difference (p < 0.005) between Groups A (17.7 %) and B (28.4 %). Besides, the prevalence of various ultrasonographic patterns of hepatic steatosis was different. In the elderly group A the incidence of ultrasound attenuation and focal or irregular distribution was almost doubled. The lower occurrence of hepatic steatosis in the elderly may be an expression of a natural selection, since steatosis is generally associated with factors of vascular risk and chronic liver diseases, which may cause a reduced survival. The greater prevalence of ultrasound attenuation pattern in the elderly may be an expression of advanced steatosis and/or micro-irregular distribution of fatty hepatocytes. The high incidence of focal or irregular pattern may depend on vascular alterations of the liver causing focal fat overload.