Endocrine Abstracts

Introduction: Metabolic steatopathy is a public health problem, and its therapeutic management remains a challenge primarily relying on lifestyle and dietary measures. The degree of liver fibrosis represents the major prognostic factor for this condition. The objective of this study was to investigate the impact of obesity and android fat distribution on the progression of hepatic fibrosis in metabolic steatopathy.

Patients and Methods: We conducted a prospective, descriptive study including patients diagnosed with metabolic steatopathy between March 2021 and December 2022. Age and various medical histories were collected. Anthropometric measurements were taken, and a biological assessment, including metabolic and hepatic panels, was performed. liver fibrosis assessment using transient elastography was conducted, with advanced fibrosis defined as liver elasticity ≥ 9.7 kPa.

Results: We included 139 patients with an average age of 54.2±10.7 years and a gender ratio of 0.53. Histories of type 2 diabetes, hypertension, and dyslipidemia were noted in 43.5%, 46.4%, and 31.2% of patients, respectively. Obesity was found in 52.6%, and android fat distribution was observed in 87.3% of patients. Advanced hepatic fibrosis was noted in 15.6% of patients. In analytical study, patients with advanced fibrosis had significantly higher body mass index (BMI) and waist circumference (WC) with P-values of 0.03 and 0.024, respectively. The study of BMI and WC performance in predicting advanced fibrosis showed the superiority of WC with areas under the ROC curve of 0.63 (95% CI 0.5–0.779) and 0.7 (95% CI 0.6–0.833), respectively. The BMI cutoff was 30.6 kg/m² with a sensitivity of 65% and specificity of 50%. The WC cutoff was 103.5 cm with a sensitivity of 82.4% and specificity of 40%.

Conclusion: Android-type obesity has a more pronounced correlation with advanced fibrosis than overall obesity. Therefore, it is imperative to systematically include the assessment of this parameter in the management of this pathology.