Evaluation of Hepatic Fibrosis and Hepatic Steatosis by Pulse Elastography (FIBROSCAN/CAP) in Asymptomatic Patients about 170 Cases at the Donka CHU National Hospital in Conakry — Oak Academic Publishing
Research ArticleOpen AccessGoogle Scholar indexed
Evaluation of Hepatic Fibrosis and Hepatic Steatosis by Pulse Elastography (FIBROSCAN/CAP) in Asymptomatic Patients about 170 Cases at the Donka CHU National Hospital in Conakry
Department of Hepato-Gastroenterology, The Donka National Hospital, Conakry, Guinea
,
Internal Medicine Department, Centre Hospitalier Universitaire Communautaire de Bangui, Bangui, Central African Republic
,
Department of Hepato Gastroenterology, Angré University Hospital, Abidjan, Ivory Coast
,
Department of Hepato-Gastroenterology, The Donka National Hospital, Conakry, Guinea
,
Department of Hepato-Gastroenterology, The Donka National Hospital, Conakry, Guinea
,
Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University, Conakry, Guinea
,
Department of Hepato-Gastroenterology, The Donka National Hospital, Conakry, Guinea
,
Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University, Conakry, Guinea
,
Department of Internal Medicine, Donka National Hospital, Conakry, Guinea
,
Department of Internal Medicine, Donka National Hospital, Conakry, Guinea
,
Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University, Conakry, Guinea
1 Department of Hepato-Gastroenterology, The Donka National Hospital, Conakry, Guinea
2 Internal Medicine Department, Centre Hospitalier Universitaire Communautaire de Bangui, Bangui, Central African Republic
3 Department of Hepato Gastroenterology, Angré University Hospital, Abidjan, Ivory Coast
4 Department of Hepato-Gastroenterology, The Donka National Hospital, Conakry, Guinea
5 Department of Hepato-Gastroenterology, The Donka National Hospital, Conakry, Guinea
6 Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University, Conakry, Guinea
7 Department of Hepato-Gastroenterology, The Donka National Hospital, Conakry, Guinea
8 Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University, Conakry, Guinea
9 Department of Internal Medicine, Donka National Hospital, Conakry, Guinea
10 Department of Internal Medicine, Donka National Hospital, Conakry, Guinea
11 Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University, Conakry, Guinea
<b>Introduction: </b>Fibroscan is a recent, non-invasive and non-irradiating diagnostic method. It is based on the principle of ultrasound, which enables liver tissue elasticity to be quantified using a probe, and fibrosis to be assessed. Fibroscan measures both elasticity correlated with hepatic fibrosis and CAP correlated with steatosis. The aim of this study was to evaluate hepatic fibrosis and steatosis using pulse elastometry (Fibroscan/CAP). <b>Methods: </b>This was<b> </b>a descriptive and analytical cross-sectional study in which 170 patients were included. It was conducted from October 1 2021 to December 31 2023, <i>i.e</i>. 27 months, in an outpatient clinic in the hepato-gastroenterology department of the Donka national hospital of the CHU Conakry. <b>Results: </b>Of the 170 patients identified, 87 were male (51%) and 83 female (49%), giving a M/F sex ratio of 1.04. The average age of our patients was 40. The 30 - 50 age group was the most affected, with a frequency of 58.23% (n = 99), followed by the 50 age group with a frequency of 29.41% (n = 50). Hepatomegaly, steatotic liver on ultrasonography, transaminase elevation and obesity were the main indications, respectively: (21.76%), (17.65%), (14.71%), and (13.53%). The examinations were requested by hepatogastroenterologists (47.06%), diabetologists (35.88%) and general practitioners (29%). Of the 170 patients, 100 patients (58.82%) had no significant fibrosis F0F1, 39 (22.94%) had moderate fibrosis F2, 20 patients (11.76%) had severe fibrosis F3 and 11 patients (6.47%) had fibrosis F4. Hepatic steatosis: 62 patients (36.47%) had no S0 steatosis; 29.41% had S1 steatosis, 20% had S2 steatosis and 24 patients (14.11%) had S3 steatosis. Abdominal ultrasound revealed a normal liver in 67.05% of patients, hepatic steatosis in 29.41% and non-decompensated cirrhosis in 6 cases. Thus, 108 patients had the parameters required to calculate the Fatty Liver Index (FLI), steatosis was present in 20% of our patients, while 29.41% had an undetermined status and 24 14.11% had a normal FLI. <b>Co</b><b>n</b><b>clusion: </b>Identifying subjects at risk of metabolic steatopathy, diagnosing and managing these patients is a public health issue and one of the future challenges of hepato-gastroenterology. Fibroscan is an increasingly popular screening tool for hepatic fibrosis and steatosis. The fight against obesity must be a priority.
Bravo, A., Shet, S.G., Chopra, S., et al. (2001) Liver Biopsy. The New England Jou r nal of Medicine , 334, 495-500. https://doi.org/10.1056/NEJM200102153440706
Younossi, Z.M., Koenig, A.B., Abdelatif, D., Fazel, Y., Henry, L. and Wymer, M. (2016) Global Epidemiology of Non Alcoholic Fatty Liver Disease—Meta-Analytic Assessment of Prevalence, Incidence, and Outcomes. Hepatology , 64, 73-84. https://doi.org/10.1002/hep.28431
Ratziu, V., Bellentani, S., Cortez-Pinto, H., et al. (2010) A Position Statement on NAFLD/NASH Based on the EASL 2009 Special Conference. Journal of Hepatology , 53, 372-384. https://doi.org/10.1016/j.jhep.2010.04.008
Leroy, V. and Hilleret, M.N. (2005) Evaluation of Hepatic Fibrosis. Hépato - Gastro & Oncologie Digestive , 12, 251-259.
Chalasani, N., Younossi, Z.M., Lavine, J.E., Charlton, M., Cusi, K., Rinella, M., et al. (2018) The Diagnosis and Management of Non Alcoholic Fatty Liver Disease: Practice Guidance from the American Association for the Study of Liver Diseases. H e patology , 67, 328-357. https://doi.org/10.1002/hep.29367
Brener, S. (2015) Transient Elastography for Assessment of Liver Fibrosis and Steatosis: An Evidence-Based Analysis. Ontario Health Technology Assessment Series , 15, 1-45.
Sandrin, L., Fourquet, B., Hasquenoph, J.M., Yon, S., Fournier, C., Mal, F., Christidis, C., et al. (2003) Transient Elastography: A New Non-Invasive Method for Assessment of Hepatic Fibrosis. Ultrasound in Medicine and Biology , 29, 1705-1713. https://doi.org/10.1016/j.ultrasmedbio.2003.07.001
Castera, L., Foucher, J., Bertet, J., et al. (2006) FibroScan and FibroTest to Assess Liver Fibrosis in HCV with Normal Aminotransferases. Hepatology , 43, 373-374. https://doi.org/10.1002/hep.21019
Hezode, C., Rosa, I. and Castera, L. (2006) Evolution of Liver Stifness Measurement during Antiviral Therapy in Patients with Chronic Hepatitis C. Journal of Hepato l ogy , 44, S226. https://doi.org/10.1016/S0168-8278(07)62195-3
Milligo, G.R.C., Samandoulougou, A., Yaméogo, N.V., Yaméogo, A.R., Kologo, K.J., Toguyeni, J.Y., et al. (2014) Metabolic Syndrome in Hypertensive Patients in the Cardiology Service Yalgado Ouedraogo of Ouagadougou, Burkina Faso. Pan Afr i can Medical Journal , 19, Article 290.
Diendére, J., Kabore, J., Somé, J.W., Tourisme, G., Zeba, A.N. and Tintouin, H. (2019) Prevalence and Factors Associated with Overweight and Obesity among Rural and Urban Women in Burkina Fasso. The Pan African Medical Journal , 34, Article 199. https://pubmed.ncbi.nlm.nih.gov/32180873/
Steatosis
CHU Conakry
Iqbal, U., Perumpail, B., Akhtar, D., Kim, D. and Ahmed, A. (2019) The Epidemiology, Risk Profiling and Diagnostic Challenges of Nonalcoholic Fatty Liver Disease. Medicines . 6, Article 41. https://doi.org/10.3390/medicines6010041
Bamouni, Y.A., Cissé, R., Diallo, O., Lougue-Sorgho, L.C., Napon, A.M., Sermé, A.K., et al. (2012) Etiological Factors Associated with Hepatic Steatosis Discovered Accidentally by Ultrasound in Ouagadougou, Burkina Fasso. Journal Africain D ’ Imagerie Médicale , 4, 21-30.
Younossi, Z., Anstee, Q.M., Marietti, M., Hardy, T., Henry, L., Eslam, M., et al. (2018) Global Burden of NAFLD and NASH: Trends, Predictions, Risk Factors and Prevention. Nature Reviews Gastroenterology & Hepatology , 15, 11-20. https://doi.org/10.1038/nrgastro.2017.109
Wang, C.Y., Lu, W., Hu, D.S., Wang, G.D. and Cheng, X.J. (2014) Diagnostic Value of Controlled Attenuation Parameter for Liver Steatosis in Patients with Chronic Hepatitis B. World Journal of Gastroenterology , 20, 10585-10590. https://doi.org/10.3748/wjg.v20.i30.10585
Sasso, M., Audière, S., Kemgang, A., Gaouar, F., Corpechot, C., Chazouillères, O., et al. (2016) Liver Steatosis Assessed by Controlled Attenuation Parameter (CAP) Measured with the XL Probe of the Fibroscan: A Pilot Study Assessing Diagnostic Accuracy. Ultrasound in Medicine and Biology , 42, 92-103. https://doi.org/10.1016/j.ultrasmedbio.2015.08.008
Younossi, Z.M., Stepanova, M., Afendy, M., et al. (2011) Changes in the Prevalence of the Most Common Causes of Chronic Liver Diseases in the United Sates from 1998 to 2008. Clinical Gastroenterology and Hepatology , 9, 524-530. https://doi.org/10.1016/j.cgh.2011.03.020
Seto, W.K., Hui, R.W.H., Mak, L.Y., Fung, J., Cheung, K.S., Liu, K.S.H., et al. (2018) Association between Hepatic Steatosis, Measured by Controlled Attenuation Parameter, and Fibrosis Burden in Chronic Hepatitis B. Clinical Gastroenterology and Hepatology , 16, 575-583. https://doi.org/10.1016/j.cgh.2017.09.044
Boursier, J., Konate, A., Guilluy, M., et al. (2008) Learning Curve and Interobserver Reproducibility Evaluation of Liver Stiffness Measurement by Transient Elastogrphy. European Journal of Gastroenterology & Hepatology , 20, 693-701. https://doi.org/10.1097/MEG.0b013e3282f51992
Choi, H.S.J., Brouwer, W.P., Zanzjir, W.M.R., Man, R.A., Feld, J.J., Hansen, B.E., et al. (2020) Nonalcoholic Steatohepatitis Is Associated with Liver-Related Outcomes and All-Cause Mortality in Chronic Hepatitis B. Hepatology , 71, 539-548. https://doi.org/10.1002/hep.30857
Chen, Y., Fan, C., Chen, Y., Liu, H., Wang, S., Dong, P., et al. (2017) Effect of Hepatic Steatosis on the Progression of Chronic Hepatitis B: A Prospective Cohort and in vitro Study. Oncotarget , 8, 58601-58610. https://doi.org/10.18632/oncotarget.17380
Lanthier, N. (2018) Non-Alcoholic Steatohepatitis in 2018. Louvain Médical , 137, 308-313.
Joseph, A.E., Saverymutu, S.H., Al-Sam, S., Cook, M.G. and Maxwell, J.D. (1991) Comparison of Liver Histology with Ultrasonography in Assessing Diffuse Parenchymal Liver Disease. Clinical Radiology , 43, 26-31. https://doi.org/10.1016/S0009-9260(05)80350-2
Huwart, L., Sempoux, C., Vicaut, E., et al. (2008) Magnetic Resonance Elastography for the Noninvasive Staging of Liver Fibrosis. Gastroenterology , 135, 32-40. https://doi.org/10.1053/j.gastro.2008.03.076
Bedogni, G., Bellentani, S., Miglioli, L., Masutti, F., Passalacqua, M., Castiglione, A., et al. (2006) The Fatty Liver Index: A Simple and Accurate Predictor of Hepatic Steatosis in the General Population. BMC Gastroenterology , 6, Article No. 33. https://doi.org/10.1186/1471-230X-6-33
Fonkoua, S. (2019) Metabolic Risk Factors Associated with NAFLD. Abidjan Ph.D. Thesis, University Felix Houphouët Boigny of Abidjan, Ivory Coast.
Diallo, M.S., Wann, T.A., Diallo, D., Diallo, K., Bah, M.L.Y., Sylla, S.M., et al. (2023) Autoimmune Hepatitis Complicated by Cirrhosis: About an Observation at the Conakry University Hospital. Jaccr Africa , 7, 65-70.