S2691 Unraveling the Relationship Between CAP Score and E-value and Metabolic Markers in Fatty Liver Disease: Insights from a Large Cohort in Kannur District

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a growing global health concern. The primary aim of this study was to identify demographic, clinical, and biochemical factors, particularly insulin resistance markers such as HOMA-IR, QUICKI, APRI, FIB-4, TYG, TYGBMI, and METS-IR, that are significantly associated with significant liver fibrosis. Methods: This cross-sectional study was conducted in the Department of Gastroenterology at Aster MIMS Kannur, from June 2023 to June 2024. All patients attending the fatty liver clinic who satisfied the inclusion criteria were recruited. Data was collected comprehensively for each participant. All patients underwent an abdominal ultrasound (USG abdomen) and Fibroscan using the latest Echosens device, which provided measurements for controlled attenuation parameter (CAP) score and liver stiffness measurement (LSM or E-value). Liver fibrosis was assessed using Fibroscan, with an E-value > 8.2 kPa defined as significant fibrosis. Results: The study population of 334 participants had a median age of 42 years (interquartile range: 16), with a male predominance (74% male, 26% female). Key comorbidities included diabetes (14.7%), hypertension (8.7%), dyslipidemia (11.4%), obesity (4.2%), and reported alcohol consumption (10.2%). The cohort primarily presented with F0-F1 fibrosis (216 patients), followed by F2 (39), F3 (45), and F4 cirrhosis (34). Initial analyses revealed significant associations of diabetes and dyslipidemia with abnormal ultrasound findings, Fibroscan E-values, and FIB-4. Univariate logistic regression identified HOMA-IR (mean 4.337 vs 6.260 for non-significant vs significant fibrosis), TYG Index, TYGBMI, and METS-IR (cutoff 39.9) as significantly associated with significant fibrosis (E > 8.2 kPa, all P < 0.05). Conclusion: This study confirms the multifactorial nature of liver fibrosis in fatty liver disease. The distribution of fibrosis stages highlights that a large proportion of patients present with mild to moderate fibrosis. Several clinical and metabolic markers, including Diabetes, DLP, and insulin resistance markers like HOMA-IR, TYG Index, TYGBMI, and METS-IR, showed significant associations with fibrosis in univariate analyses. The high mean HOMA-IR in the significant fibrosis group, and the strong associations of TYG, TYGBMI, and METS-IR, underscore the critical role of insulin resistance and metabolic dysfunction in disease progression. Disclosure: The authors used Gemini AI for writeup and grammar correction.