Association between spleen volume and liver disease using MR images from 40,000 UKBB subjects

In chronic liver diseases such as metabolic dysfunction-associated steatotic liver disease (MASLD; previously called non-alcoholic fatty liver disease, NAFLD), liver damage can manifest in elevated portal vein pressure and splenomegaly (enlarged spleen). However, the association between spleen volume and MASLD and related type 2 diabetes (T2D) is not well understood.

In cases of advanced chronic liver disease, the increased resistance to perfusion due to fibrosis can cause portal hypertension, meaning increased pressure within the portal venous system. Portal hypertension is considered clinically significant (csPH) when the hepatic venous pressure gradient (HVPG) >10 mmHg.  The increased portal pressure can propagate to the splenic vein, which can lead to spleen enlargement.

Research conducted by Uppsala University and Antaros Medical looked at the association between spleen volume and NAFLD (now MASLD) and T2D using data from the UK Biobank. The UK Biobank contains comprehensive clinical data and magnetic resonance (MR) images of more than 40,000 individuals. In this study, an automated deep learning-based image segmentation algorithm was developed and used to evaluate the spleen volumes of 37,066 participants.

Spleen volume was found to be associated with NAFLD, liver fat fraction, liver volume, and liver fibrosis (as assessed using FIB-4). Notable increases in spleen volume at low liver volumes and liver fat levels were also observed. Together, these results suggest a link between spleen volume and liver disease, even at early stages, which is potentially due to an initial rise in portal vein pressure.

MRI provides a powerful platform for assessing pathophysiological features including the structure, composition, and stiffness of the liver and spleen, hemodynamics of the portal vein and hepatocyte function. You can read more about our work with portal hypertension and liver disease here.

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Title: Spleen volume is independently associated with non-alcoholic fatty liver disease, liver volume, and liver fibrosis
Authors: Helgesson S, Tarai S, Lagner T, Ahlström H, Johansson L, Kullberg J, Lundström E
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