Introduction

Metabolic dysfunction–associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), is now recognized as the leading cause of chronic liver disease. Diagnosis can be made by simple tests available in primary care setting, particularly abdominal ultrasound and FIB4 index. More accurate assessment of fibrosis and specialized follow-up may be necessary to prevent progression to cirrhosis or hepatocellular carcinoma.

Aims & Methods

The aim of our study was to define the prevalence of hepatic steatosis and MASLD in a hospital cohort, to analyze the factors associated with MASLD in our population, and to select patients who need more accurate fibrosis assessment and closer follow up. A prospective descriptive and analytical study was conducted over a 7 months period. After consenting to participate to the study, patients consulting our department for gastroenterological or proctological complaints were included, excluding those followed up for known chronic liver disease. Epidemiologic and clinical data were collected, followed by abdominal ultrasonography. We first divided our population into 2 groups according to the presence of steatosis on ultrasound. FIB4 index were then calculated for patients with steatosis. Statistical analysis was performed with IBM SPSS Statistics 20.0 software.

Results

Among the 450 patients included, the prevalence of hepatic steatosis was 24.88 %. The mean age was 50.6 (16 - 98 years). Older age (p = 0.005), obesity (p = 0.02) and diabetes (p < 0.001) were significantly associated with the presence of steatosis. In the steatotic population, 37.5% were diabetic (88.09% of type 2 diabetes), and 20.5% hypertensive. All these patients were overweight or obese, with a mean BMI of 29.01 kg/m² and a mean waist circumference of 92.7 cm. Seven point forteen percent were drinking alcohol, with an average intake of 25 g/week. Twenty-two patients (29.34%) were found to have a Fib4 > 1.3. Comparing these two steatotic subgroups, we found a significant difference in diabetes and obesity, which were significantly more prevalent in the Fib4>1.3 group (p<0.001 and p=0.02, respectively).

Conclusion

Our study confirms the high prevalence of hepatic steatosis, especially MASLD, which becomes a major public health problem. Advanced age, diabetes and obesity were the main risk factors associated with MASLD in our study. These data highlight the importance of systematic screening for fibrosis in these populations, as well as specialized follow-up.