P-20 METABOLIC ASSOCIATED FATTY LIVER DISEASE: FIBROSIS AND SARCOPENIA FREQUENCIES

Introduction

Metabolic fatty liver (MAFLD) is a global health problem with a prevalence of about 25%. It consists in a multissystemic disease correlated with many others comorbidities. Progressive disease or steatohepatitis is associated with worst outcomes, more inflammation and fibrosis. Liver fibrosis stratifies patients with more propensity for cardiovascular deaths and cirrhosis. Nowadays, elastography is able to detect safely fibrosis. Risk factors identification which are associate with progressive disease and cirrhosis complications allow adequate treatment for MAFLD.

Objectives

Estimate and evaluate liver fibrosis and sarcopenia in MAFLD present in high risk patients – obesity, metabolic syndrome and diabetes 2 type diseases. Identification of risk factors for progressive disease.

Methods

All patients enrolled were submitted to clinical, antropometric assessment and blood tests. The non-invasive assessment of MAFLD and fibrosis stage was performed by ultrasound, FLI-score and elastography. Sarcopenia was evaluated by Dual energy X-ray absorptiometry (DXA) – Baungarten index- and by bioimpedancy. Numerical variables were analyzed by Mann-whitney and Anova tests. Categorical variables were analysed by Fischer´s exact test.

Results

42 patients were included until now, 87% women e 13% men; Median age was 66 (52-61) years. Three patients did not had steatosis(n=26). Eight participants (31%) had fibrosis > = 2. One patient was classified as sarcopenic, Median IMC was 31,8 Kg/m ² (22,8-44); Coefficient attenuation parameter (CAP), ferritin and D vitamin were not different between the fibrosis and non fibrosis groups. Fibrosis was associated with higher AST, p value of 0,04; ALT and fibrosis was not correlated, p value of 0,07.

Conclusion

All considerations must be taken with caution because of the small group of patients.The steatosis high risk study population: metabolic syndrome, obesity and diabetes type 2 patients had a higher fibrosis frequency than in general population, 31%, and no correlation with sarcopenia in this small population. The AST level was correlated with fibrosis in steatosis group patients.