Facteurs Associés à la Fibrose Hépatique au Cours de la Stéatopathie Métabolique à Abidjan
Fibrose hépatique pendant la stéatopathie métabolique à Abidjan
DOI:
https://doi.org/10.5281/hra.v2i3.5409Keywords:
NAFLD, NASH, impulse elastometry, steatosis, fibrosis, AbidjanAbstract
RÉSUMÉ
Introduction. Le faible nombre d’études sur les facteurs de risque de la fibrose hépatique dans la stéatopathie métabolique (NAFLD) en Afrique subsaharienne nous a conduit à initier ce travail dont le but était de déterminer les facteurs associés à la fibrose hépatique au cours de la NAFLD diagnostiquée par l’élastométrie impulsionnelle (Fibroscan©) chez le noir africain. Méthodes. Nous avons inclus 51 patients recrutés au sein du CHU de Cocody et au siège de la Société Générale des Banques de Côte d’Ivoire dans la ville d’Abidjan. Tous les patients ont effectué un Fibroscan®. Il existait une fibrose significative lorsque F>=2. La stéatose était présente si S >215dB/m. Les tests de Chi 2 et de la régression logistique ont été utilisés. Ils étaient significatifs lorsque p<0,05. Résultats. La NASH était présente chez 54,1% (n=28), la NAFL chez 46,9% (n=23). 58,7% des patients NAFLD (n=30) avaient une fibrose significative. 96 % des patients avaient un IMC ≥ 25kg/m². 56,9% des patients présentaient une stéatose modérée à sévère. Les facteurs de risque associés à la survenue de fibrose significative en analyse uni variée étaient : le sexe masculin, l’âge supérieur à 40 ans, le surpoids, l’obésité, les grades de stéatose légère et modérée, l’obésité tronculaire et le cholestérol total. L’obésité tronculaire était le seul facteur indépendamment associé à la survenue de la fibrose hépatique en analyse multi variée. Conclusion. L’obésité est le principal facteur de risque de survenue de fibrose et de stéatose chez les patients NAFLD.
ABSTRACT
Introduction. Metabolic steatopathy (NAFLD) is the hepatic manifestation of metabolic syndrome. The low number of studies on the evaluation of fibrosis in sub-Saharan black Africa led us to initiate this work, the aim of which was to determine the factors associated with fibrosis in course of NAFLD diagnosed by impulse elastometry (Fibroscan©) in black African subjects. Methods. We included 51 patients recruited within the Cocody University Hospital and at the headquarters of the Société Générale des Banques de Côte d'Ivoire in the city of Abidjan. All patients underwent a Fibroscan®. There was significant fibrosis when F>=2. Steatosis was present if S >215dB/m. Chi square and logistic regression tests were used. They were significant when p<0.05. Results. NASH was present in 54.1% (n=28), NAFL in 46.9% (n=23). 58.7% of NAFLD patients (n=30) had significant fibrosis with a predominance for NASH patients. 96% of patients had a BMI ≥ 25kg/m². 56.9% of patients presented moderate to severe steatosis. The risk factors associated with the occurrence of significant fibrosis in univariate analysis were: male sex, age over 40 years, overweight, obesity, grades of mild and moderate steatosis, truncal obesity and total cholesterol. Truncal obesity was the only factor independently associated with the occurrence of hepatic fibrosis in multivariate analysis. Conclusion. Impulse elastometry (Fibroscan®) is a non-invasive method for assessing and stratifying hepatic fibrosis and steatosis. Obesity is the main risk factor for the occurrence of fibrosis and steatosis in NAFLD patients.
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