Frequency and determinants of fatty liver disease in Congolese population: interest of Fibroscan assessing

Context and objective. FibroScan is a non-invasive examination that is more reliable than ultrasound for assessing fatty liver disease. Our objective was to assess the extent and explanatory factors of fatty liver disease assessed by FibroScan in a group of Congolese patients followed in the units of Hepato-gastroenterology. Methods. A multicenter cross-sectional study was conducted between 2022 and 2024 in 13 hospitals in Kinshasa. Apart from ultrasound and FibroScan (Controlled Attenuation Parameter = CAP function and elastometry measurement), the other parameters of interest were comorbidities, anthropometric measurements, lipid profile, B and C viral serology and transaminases.  The stages of steatosis (S0 to S3) and liver fibrosis (F0 to F4) by FibroScan were defined according to the Echosens interpretation guide. Results. Three hundred sixteen patients (60.8% men; 14% viral hepatitis B; 7% viral hepatitis C; 3% cirrhotic; 10% diabetic; 26% alcoholics and 37% obese) were examined. The mean PAC was 247.9 ± 62.8 dB/m, and varied with BMI [OR: 3.28 (CI 95 %: 2.35-4.21)], total cholesterol [13.41(8.94-17.88)], and history of diabetes [23.98(4.75-43.21)]. Among alcoholics, 26 % had S3 steatosis and 3 % S2 steatosis whereas in diabetics 56 % had S3 steatosis and 9 % S2 steatosis. In obese patients, 48 % had S3 and 14 % S2 steatosis. The agreement between ultrasound and FibroScan was low (Kappa 0.13 and 68 % of divergent protocols). Among S3 patients, 9 % had F4 liver fibrosis. Conclusion. the FibroScan revealed a significant frequency of fatty liver disease among alcoholic, obese and diabetic patients. In the severe stage of fatty liver disease, approximately one in ten patients already had liver fibrosis. Agreement between the FibroScan and ultrasound results was low. Received: October 21th, 2024 Accepted: January 4th, 2025 https://dx.doi.org/10.4314/aamed.v18i2.3