Associations between use of aspirin and MRI-derived liver fat and fibroinflammation
Author(s)
Feng, Qi
Manousou, Pinelopi
Izzi-Engbaeya, Chioma N
Liu, Jun
Woodward, Mark
Type
Journal Article
Abstract
Background: The effects of aspirin on hepatic steatosis and fibroinflammation are unclear. The study aimed to examine the association between aspirin use and liver MRI-derived liver fat and corrected T1 (cT1).
Methods: We used UK Biobank imaging cohort data. Aspirin use was self-reported at baseline and imaging assessment, and the main exposures were aspirin use at imaging assessment and longitudinal aspirin use patterns (never users, initiators, discontinuers, vs. persistent users). Outcomes were MRI-derived liver fat (%) and cT1 (ms). Multivariable adjustment analyses and inverse probability of treatment weighting (IPTW) analyses were performed, accounting for demographic, lifestyle and clinical factors.
Results: We included 36413 participants (mean age 64.6 years, 51.4% female). Aspirin use at imaging assessment was associated with lower liver fat (-0.35 (95% CI: -0.51, -
33 0.20)) and slightly higher cT1 (5.13 (95% CI: 3.23, 7.03)). Analyses on longitudinal aspirin use pattern showed that compared to never users, initiators and persistent users showed lower liver fat (-0.48 (-0.69, -0.28) and (-0.24 (-0.45, -0.02)) and higher cT1 (2.94 (0.38, 5.49) and 8.31 (5.65, 10.97)). IPTW analyses showed consistent results. Conclusion: In this large population-based cohort, aspirin use was linked to reduced liver fat, but a small, clinically insignificant (i.e. <80ms) increase in cT1. These findings suggest aspirin may mitigate steatosis through metabolic pathways but does not necessarily rapidly reverse fibroinflammatory injury.
Methods: We used UK Biobank imaging cohort data. Aspirin use was self-reported at baseline and imaging assessment, and the main exposures were aspirin use at imaging assessment and longitudinal aspirin use patterns (never users, initiators, discontinuers, vs. persistent users). Outcomes were MRI-derived liver fat (%) and cT1 (ms). Multivariable adjustment analyses and inverse probability of treatment weighting (IPTW) analyses were performed, accounting for demographic, lifestyle and clinical factors.
Results: We included 36413 participants (mean age 64.6 years, 51.4% female). Aspirin use at imaging assessment was associated with lower liver fat (-0.35 (95% CI: -0.51, -
33 0.20)) and slightly higher cT1 (5.13 (95% CI: 3.23, 7.03)). Analyses on longitudinal aspirin use pattern showed that compared to never users, initiators and persistent users showed lower liver fat (-0.48 (-0.69, -0.28) and (-0.24 (-0.45, -0.02)) and higher cT1 (2.94 (0.38, 5.49) and 8.31 (5.65, 10.97)). IPTW analyses showed consistent results. Conclusion: In this large population-based cohort, aspirin use was linked to reduced liver fat, but a small, clinically insignificant (i.e. <80ms) increase in cT1. These findings suggest aspirin may mitigate steatosis through metabolic pathways but does not necessarily rapidly reverse fibroinflammatory injury.
Date Issued
2026-05-01
Date Acceptance
2026-02-04
Citation
Diabetes, Obesity and Metabolism, 2026, 28 (5), pp.3895-3902
ISSN
1462-8902
Publisher
Wiley
Start Page
3895
End Page
3902
Journal / Book Title
Diabetes, Obesity and Metabolism
Volume
28
Issue
5
Copyright Statement
© 2026 The Author(s). Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
License URL
Publication Status
Published
Date Publish Online
2026-02-18