Endocrine Abstracts

Introduction: Liver steatosis currently represents a hepatic manifestation of metabolic syndrome. It occurs more frequently in patients with obesity, and liver biopsy remains the gold standard for the positive diagnosis of this condition. In recent decades, the positive diagnosis of hepatic steatosis has increasingly relied on non-invasive methods such as Controlled Attenuation Parameter (CAP). The objective of this study was to investigate the prevalence of hepatic steatosis diagnosed via CAP among obese patients and to determine the factors associated with the occurrence of moderate to severe steatosis in this group.

Methods: This is a retrospective, single-center, descriptive study including all obese patients undergoing screening for hepatic steatosis via CAP integrated into the Fibroscan Echosens 502 device. We collected age, various medical histories, anthropometric measurements, and CAP values. Obesity and its different classes were defined according to the World Health Organization recommendations. The different degrees of hepatic steatosis were defined as follows: Absence of steatosis (S0): CAP<294 dB/m, Mild steatosis (S1): CAP<310 dB/m, Moderate steatosis (S2): CAP<331 dB/m, Severe steatosis (S3): CAP≥331 dB/m.

Results: Our population included 94 patients with an average age of 53.42±11.4 years, ranging from 28 to 81 years, and a gender ratio of 0.3. Various medical histories were distributed as follows: Type 2 diabetes (29%), hypertension (23.7%), dyslipidemia (20.4%), hypothyroidism (7.5%), and obstructive sleep apnea syndrome (OSA) (1.1%). The mean BMI was 35.72±4.8 kg/m², ranging from 30 to 54.5 kg/m². We observed hepatic steatosis in 50% of patients (n=47). The mean CAP value was 290.22±60 dB/m, ranging from 109 to 400 dB/m. The different degrees of hepatic steatosis were distributed as follows: S1 (14.9%), S2 (29.8%), S3 (55.3%). In univariate analysis, factors associated with the occurrence of moderate to severe steatosis (S2-S3) were male gender (P=0.028), associated dyslipidemia (P=0.047), and BMI ≥35 kg/m² (P=0.037). In multivariate analysis, male gender and BMI ≥35 kg/m² were independently associated with the occurrence of moderate to severe steatosis in obese patients, with respective P-values of 0.02 and 0.03, and odds ratios of 3.47 and 2.68.

Conclusion: Our study suggests a notable prevalence of hepatic steatosis in obese patients, with greater severity in males with Class II and III obesity.