[Cryptogenic steatotic liver disease: a clinical and instrumental study]

Recent classification of steatotic liver disorders was published in 2023, where a new form - cryptogenic steatotic liver disease (CSLD) was introduced.

To assess the prevalence of CSLD within the spectrum of liver disorders associated with steatosis, and to describe its clinical and instrumental characteristics.

A retrospective search was performed in the database of subjects underwent vibration-controlled transient liver elastography (n=4,673). Criteria of CSLD and other steatotic liver diseases were based on EASL guidelines. Liver stiffness and data of controlled attenuation parameter assessment were used to establish stage of liver fibrosis and degree of steatosis of the liver. Body composition was evaluated using bioimpedance analysis. Serum parameters of lipid and carbohydrate metabolism were assessed.

CSLD was found in 22 (0.8%) of total number of subjects with the presence of hepatic steatosis (n=2,643). Advanced stages of fibrosis (F2-F4) and degree of steatosis (S3) were less prevalent in CSLD group compared to MASLD: 9.1% vs 29.3%; p=0.02; S3 27.3% vs 67.6%; p<0.001 accordingly. Compared to the control group (n=266) without steatosis and fibrosis, patients with CSLD had a greater body mass index (Median [Q1-Q3]: 24.1 [22.1-24.5] kg/m² vs 22.4 [20.7-23.7] kg/m²; p=0.008), primarily due to greater fat mass (19.0 [16.6-26.7] kg vs 16.4 [12.2-20.5] kg; p=0.03). No significant difference was found between the CSLD and the control group on the demographic characteristics, serum lipid and carbohydrate metabolism parameters.

CSLD is a rare condition. Patients with CSLD had greater fat mass compared to the control group; however, both groups were characterized by normal values of body mass index, serum lipid and carbohydrate metaboliс parameters.