Non-invasive screening tools for fibrosis assessment in obese individuals

Liver fibrosis is a critical aspect of non-alcoholic fatty liver disease (NAFLD) progression, serving as a turning point in chronic liver disease. The aim of our study was to assess fibrosis in obese patients based on non-invasive screening tools. This is a cross-sectional study conducted in 40 female obese patients. As part of the fibrosis screening protocol, all patients underwent liver function tests, FIB-4 score calculation, and liver elastography (FibroScan). Mean age was 43.56 ± 12.75 years. Mean duration of obesity progression was 12.13 ± 5.45 years. Mean body mass index (BMI) was 40.36 ± 7.17 kg/m 2 and 45% of the study population had morbid obesity. Mean AST and ALT levels were 23.63 ± 9.19 UI/L and 22.75 ± 8.23 UI/L, respectively. Cholestasis was detected in 20% of patients, while liver cytolysis was observed in 15% of the cohort. Thrombocytopenia was found in only 2.7% of participants. Most patients (87.5%) had a FIB-4 below 1.3 with none exceeding 2.67. Among patients with a FIB-4 score greater than 1.3, 60% had elasticity rates greater than 9.6 kPa. Considering the elasticity rates thresholds, only 20% exceeded 9.6 kPa, indicating advanced fibrosis. Based on FibroScan results, our study revealed fibrosis in 90% of which 37.5% were in the advanced stage (F ≥ 2). Among patients with fibrosis identified by FibroScan, only 15% of this group had a FIB-4 > 1.3, and 38% of patients with FIB-4 > 1.3 had advanced fibrosis. The findings of our study underscore the role of FibroScan in identifying fibroses as well as its advanced stage in patients with NAFLD.