Impact of genetic variants linked to liver fat and liver volume on MRI-mapped body composition

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Background & Aims: A quarter of the world population is estimated to have metabolic dysfunction-associated steatotic liver disease. Here, we aim to understand the impact of liver trait-associated genetic variants on fat content and tissue volume across organs and body compartments and on a large set of biomarkers. Methods: Genome-wide association analyses were performed on liver fat and liver volume estimated with magnetic resonance imaging in up to 27,243 unrelated European participants from the UK Biobank. Identified variants were assessed for associations with fat fraction and tissue volume in >2 million 'Imiomics' image elements in 22,261 individuals and with circulating biomarkers in 310,224 individuals. Results: ). Conclusions: Liver fat-increasing variants were mostly linked to fat fraction of the liver and were positively associated with some adverse metabolic biomarkers and negatively with lipids. In contrast, liver volume-associated variants showed a less consistent pattern across organs and biomarkers. Impact and implications: systemic effects remains poorly defined. By integrating genome-wide association analyses and high-resolution neck-to-knee magnetic resonance imaging data through the Imiomics framework, this study reveals distinct genetic architectures for liver fat and liver volume, including sex-specific effects. These findings provide new insights into the biological, organ-level, tissue-specific, and systemic characteristics of steatotic liver disease and its genetic determinants. The results may inform the development of precision imaging genetic approaches, biomarker discovery, and stratified risk assessment strategies, while reinforcing the importance of incorporating sex-specific analyses in future research and clinical applications.

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