Doffoel Michel, Chaffraix Frédéric, Chahard Archia, Gras Dominique, Bonomi Odile, Bildstein Corinne, Tripon Simona, Royant Maude, Meyer Nicolas
Association de Lutte contre les Maladies du Foie ALMAF, Strasbourg, France.
Service Expert de Lutte contre les Hépatites Virales d'Alsace SELHVA, Pôle Pathologies Hépatiques et Digestives, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
PLoS One. 2025 Jan 30;20(1):e0316158. doi: 10.1371/journal.pone.0316158. eCollection 2025.
The aim of this study was to determine the prevalence of advanced hepatic fibrosis and to individualize using Bayesian analysis its associated risk factors in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) being cared for in three Alsatian cardio-metabolic health networks in the North East of France. Overall, 712 patients aged ≥18 years with a female predominance were included into a prospective, cross-sectional, and observational study. Advanced fibrosis and severe steatosis were evaluated using transient elastography (FibroScan®). The proportion of MASLD patients was 80% and 84% in women and men (difference -4.2% [-10.0; 1.9]), respectively. Advanced fibrosis was observed in 11% of patients, being more common in men (16.9%) than women (7.5%) (difference 9.4 [4.3-15.0]). Severe steatosis was also more common in men (74.9%) than women (63.4%) (difference 11.4 [4.2-18.2]). Only three of the tested variables were likely associated with advanced fibrosis: gender (OR: 1.78 [1.17-2.68]; Pr [OR >1] = 1), T2DM (OR: 1.54 [1-2.37]; Pr [OR >1] = 0.97) and hypertriglyceridemia (OR: 1.49 [0.97-2.27]; Pr (OR >1) = 0.97). In conclusion, this study confirmed the usefulness of assessing hepatic fibrosis in patients with metabolic dysfunction. Therefore, access to FibroScan® should be facilitated in all cardio-metabolic health networks.
本研究旨在确定法国东北部三个阿尔萨斯心脏代谢健康网络中接受治疗的代谢功能障碍相关脂肪性肝病（MASLD）患者晚期肝纤维化的患病率，并使用贝叶斯分析对其相关危险因素进行个体化分析。总体而言，712名年龄≥18岁且女性占多数的患者被纳入一项前瞻性、横断面观察性研究。使用瞬时弹性成像（FibroScan®）评估晚期纤维化和重度脂肪变性。女性和男性MASLD患者的比例分别为80%和84%（差异-4.2%[-10.0；1.9]）。11%的患者观察到晚期纤维化，男性（16.9%）比女性（7.5%）更常见（差异9.4[4.3-15.0]）。重度脂肪变性在男性（74.9%）中也比女性（63.4%）更常见（差异11.4[4.2-18.2]）。仅三个测试变量可能与晚期纤维化相关：性别（OR：1.78[1.17-2.68]；Pr[OR>1]=1）、2型糖尿病（OR：1.54[1-2.37]；Pr[OR>1]=0.97）和高甘油三酯血症（OR：1.49[0.97-2.27]；Pr(OR>1)=0.97）。总之，本研究证实了评估代谢功能障碍患者肝纤维化的有用性。因此，应在所有心脏代谢健康网络中促进使用FibroScan®。
