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Currently, no single universally accepted method exists to screen for malnutrition, but COntrolling NUTritional status (CONUT) score seems to be promising. This study aimed to assess the impact of myosteatosis on in-hospital outcomes and to test its association with CONUT score in people with and without type 2 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      227 patients aged\u2009&gt;\u200940 years admitted to an Internal Medicine Department were consecutively recruited, recording in-hospital outcomes. Myosteatosis was assessed as multifidus muscle to subcutaneous fat (MM\/F) attenuation ratio at computed-tomography scan. CONUT was calculated using albumin, lymphocyte count and total cholesterol. The population was stratified, based on sex-differentiated tertiles of MM\/F, in a low myosteatosis group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009152) and a high myosteatosis group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200975; top tertile of MM\/F).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The high myosteatosis group showed a higher prevalence of in-hospital death (12.5 vs. 26%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and pneumonia. Moreover, the high myosteatosis group experienced a longer length-of-stay and was more likely to have cultures positive for multi-drug-resistant germs. In-hospital death was independently associated with MM\/F ratio (OR 2.74, 95%CI 1.11\u20137.75,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.035). Diabetes did not show significant interaction on this association (\n                      <jats:italic>P<\/jats:italic>\n                      -for-interaction\u2009=\u20090.43). From multiple regression model, MM\/F was independently associated with CONUT (\u03b2\u2009=\u20090.30,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Myosteatosis was associated with adverse in-hospital outcomes. CONUT score was independently associated with the imaging-derived MM\/F ratio. Further studies specifically designed to evaluate diagnostic performance are required before CONUT can be proposed as a screening tool for myosteatosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00592-026-02785-3","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T10:46:13Z","timestamp":1788173173000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Myosteatosis is associated with adverse in-hospital outcomes and CONUT score in hospitalized internal medicine patients"],"prefix":"10.1007","author":[{"given":"Nicoletta","family":"Miano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Di Marco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Scilletta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Todaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giosiana","family":"Bosco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Di Giacomo Barbagallo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Scicali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1781-0902","authenticated-orcid":false,"given":"Salvatore","family":"Piro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonino","family":"Di Pino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"2785_CR1","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.clnu.2016.09.004","volume":"36","author":"T Cederholm","year":"2017","unstructured":"Cederholm T, Barazzoni R, Austin P et al (2017) ESPEN guidelines on definitions and terminology of clinical nutrition. 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