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

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.