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在代谢功能障碍相关脂肪性肝病中利用瞬时弹性成像(Fibroscan)评估肝纤维化和脂肪变性:来自尼日利亚贝宁城UBTH的经验

Assessing Fibrosis and Steatosis utilizing Transient Elastography (Fibroscan) in Metabolic-dysfunction Associated Steatotic Liver Disease: An Experience from UBTH, Benin City, Nigeria.

作者信息

Ugiagbe R A, Ugiagbe E E, Malu A O

机构信息

Department of Internal Medicine, Gastroenterology unit, University of Benin/University of Benin Teaching Hospital, Benin City, Edo state. E-mail:

Department of Histopathology, University of Benin/University of Benin Teaching Hospital, Benin City, Edo state.

出版信息

West Afr J Med. 2025 Feb 28;42(2):127-136.

Abstract

BACKGROUND

Metabolic dysfunction-Associated Steatotic Liver disease (MASLD) is characterized by hepatic steatosis in the absence of excessive alcohol consumption. Limited data exist on the evaluations of fibrosis in MASLD in Africa.

OBJECTIVES

The study aimed to investigate MASLD prevalence, its presentation pattern, risk factors, and the frequency, degree and risk factors of fibrosis.

METHODS

This prospective cohort study included 150 patients referred to University of Benin Teaching Hospital for MASLD. A structured questionnaire was used for data collection. Laboratory investigations followed standard procedures. After an overnight fast, 50 recruited patients underwent fibroscan examination using the Fibroscan 530 compact model from Echosens, measuring steatosis and fibrosis.

RESULTS

Out of 2390 patients, 153 had MASLD, establishing a prevalence of 6.4%. The mean age was 50.3 ± 11.5 years with a F: M ratio of 2.3:1. The mean controlled attenuation parameter (CAP) score was 269.6±60.3; and the median transient elastography (TE) score was 4.95. A strong positive correlation existed between CAP score and waist circumference (p = 0.037), Body Mass Index (BMI) (p = 0.049) and comorbidities (p = 0.049). More than 90% of MASLD patients had no symptoms, with 6% reporting right hypochondrial pain. Fibrosis showed significant associations with BMI (p =0.022), and Waist-to-Hip Ratio (p =0.032). Twelve percent of MASLD individuals exhibited severe fibrosis (≥ F2); 4% had cirrhosis, and 8% had F2 fibrosis.

CONCLUSIONS

The study highlighted a 6.4% MASLD prevalence, with central obesity, BMI, and comorbidity identified as independent risk factors. Fibroscan revealed 12% of MASLD patients had significant fibrosis with obesity and higher WHR as risk factors.

摘要

背景

代谢功能障碍相关脂肪性肝病(MASLD)的特征是在无过量饮酒情况下出现肝脂肪变性。非洲关于MASLD纤维化评估的数据有限。

目的

本研究旨在调查MASLD的患病率、表现模式、危险因素以及纤维化的频率、程度和危险因素。

方法

这项前瞻性队列研究纳入了150名因MASLD转诊至贝宁大学教学医院的患者。使用结构化问卷收集数据。实验室检查遵循标准程序。在禁食过夜后,50名招募的患者使用来自Echosens的Fibroscan 530紧凑型模型进行肝脏硬度值检测,测量脂肪变性和纤维化程度。

结果

在2390名患者中,153名患有MASLD,患病率为6.4%。平均年龄为50.3±11.5岁,女性与男性比例为2.3:1。平均受控衰减参数(CAP)评分为269.6±60.3;瞬时弹性成像(TE)评分中位数为4.95。CAP评分与腰围(p = 0.037)、体重指数(BMI)(p = 0.049)和合并症(p = 0.049)之间存在强正相关。超过90%的MASLD患者无症状,6%报告有右季肋部疼痛。纤维化与BMI(p = 0.022)和腰臀比(p = 0.032)显著相关。12%的MASLD患者表现为严重纤维化(≥F2);4%有肝硬化,8%有F2纤维化。

结论

该研究强调MASLD患病率为6.4%,中心性肥胖、BMI和合并症被确定为独立危险因素。肝脏硬度值检测显示12%的MASLD患者有显著纤维化,肥胖和较高的腰臀比为危险因素。

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