Metabolic liver disease in N'Djamena: Clinical and elastometric manifestations and associated factors

Introduction: Metabolic liver disease (MASLD) is a common condition characterised by the accumulation of fat in liver cells, which can lead to cirrhosis. The aim of this study was to describe the clinical and paraclinical manifestations and associated factors of hepatic steatosis in N'Djamena.  
Patients and methods: This was a descriptive cross-sectional study with prospective data collection over a period of two years. The study was conducted in the Gastroenterology Department of the Centre Hospitalier Universitaire la Reference Nationale (CHU-RN). Patients with risk factors for metabolic syndrome who had undergone a Fibroscan (CAP) were included. The variables studied were sociodemographic, clinical and paraclinical.                                                               
Results: A total of 253 patients were included. The mean age was 44.8 ± 9.4 years, with extremes of 12 and 70 years. There was a predominance of males (60.9%). The sex ratio was 1.55. Civil servants accounted for 49%. The main risk factor was diabetes (45.5%). Overweight and obesity accounted for 81.8%. In this series, BMI was significantly associated with hepatic steatosis (p=0.001). Laboratory tests revealed dyslipidaemia (hypertriglyceridaemia and/or hyper HDL cholesterol) in 58.5% of cases. Transaminases (ALT) were normal in 78.3% of cases. Nearly 20% of patients were carriers of the hepatitis B virus. The prevalence of hepatic steatosis diagnosed by ultrasound was 48.6% and that diagnosed by Fibroscan was 83.0%. There was a significant association between FIBROSCAN CAP values and steatosis detected by ultrasound, with a p-value <0.001. More than 38% (n=97) were at stage 2 steatosis and 15.4% (n=39) at stage 3.
Conclusion: Hepatic steatosis is increasingly common in our context. FIBROSCAN® with CAP has good diagnostic performance for its assessment.