Incidence and ultrasonographic patterns of hepatic steatosis in the elderly

A retrospective 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.