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The study examines these relationships on computed tomography (CT) scans from a large\u2010scale, racially diverse, disease\u2010focused medical biobank.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Deep learning algorithms were applied to patients with abdominal CT scans in the Penn Medicine BioBank to quantify image\u2010derived phenotypes, including spleen\u2010hepatic attenuation difference (SHAD) for hepatic steatosis (HS), liver and spleen volumes (SV), abdominal visceral and subcutaneous adipose tissue (VAT and SAT, respectively) and visceral\u2010to\u2010subcutaneous ratio (VSR). One thousand five hundred and ninety\u2010four patients (62\u2009years, 49.4% male, 59.3% White), comprising 950 nondiabetics and 644 diabetics, were included in analysis with diabetes status determined by a 6.5% haemoglobin A1c cutoff.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Diabetic patients had greater HS (SHAD \u22124.49 vs. \u22126.88\u2009Hounsfield units,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.34\u2009\u00d7\u200910\n                      <jats:sup>\u22128<\/jats:sup>\n                      ), steatosis prevalence (41.8% vs. 27.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20094.85\u2009\u00d7\u200910\n                      <jats:sup>\u22129<\/jats:sup>\n                      ) and VSR (0.62 vs. 0.55,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.69\u2009\u00d7\u200910\n                      <jats:sup>\u22123<\/jats:sup>\n                      ) than nondiabetics. In multivariate analyses adjusting for age, sex, race and body mass index (BMI), diabetes was independently associated with SHAD (odds ratios [OR] 1.04, 95% confidence interval [1.02\u20131.05]), SV (OR 4.53 [1.89\u201310.99]) and VSR (OR 2.87, [1.96\u20134.20]). Combined regression analysis showed no relationship between splenomegaly and type 2 diabetes once controlling for hepatic factors (OR 1.08, [0.95\u20131.23]), but uncovered a stronger VSR correlation (OR 1.40, [1.20\u20131.63]) than BMI (OR 1.14, [1.01\u20131.29]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hepatic steatosis, hepatomegaly and visceral adiposity on CT are associated with type 2 diabetes. Hepatic changes may influence spleen size effects on diabetes. VSR can serve as an alternative to traditional obesity metrics to accurately reflect diabetes risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70557","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T11:47:21Z","timestamp":1771415241000},"page":"3742-3751","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hepatic and abdominal adiposity in type 2 diabetes as assessed with machine learning on computed tomography scans"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1466-9252","authenticated-orcid":false,"given":"Richard H.","family":"Tran","sequence":"first","affiliation":[{"name":"Department of Radiology, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Department of Medicine University of Massachusetts Chan Medical School  Worcester Massachusetts 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