Prevalence and associated factors with non-alcoholic fatty liver disease in a group of obese women in Tunisia

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Introduction: non-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease, often undiagnosed, and its prevalence is closely linked to obesity and diabetes. This study aimed to screen for NAFLD in obese women and identify factors associated with both steatosis and fibrosis. Methods: a cross-sectional study was performed on 40 obese female patients. Data were collected through clinical examination, laboratory tests, anthropometric measurements, dietary survey. The assessment of NAFLD was based on the use of Fibroscan. Results: mean age was 43.56±12.75 years. The majority of the patients (65%) were inactive. The mean duration of obesity was 19.95±12.93 years, and morbid obesity was observed in 45% of the patients. Steatosis was detected in 75% of the population with 38.5% in its advanced stage, while fibrosis was identified in 90% of patients, of which 37.5% were in the advanced stage. Multivariable analysis revealed that the duration of obesity progression was positively associated with both the presence (B=0.12, 95% CI 1.00-1.26; p=0.034) and the severity (B=0.08, 95% CI 1.00-1.17; p=0.029) of steatosis. An active lifestyle was negatively associated with the severity of steatosis (aOR=0.14, 95% CI 0.02-0.80; p=0.027), while fiber deficiency intake was positively associated with the severity of fibrosis (aOR=7.04, 95% CI 1.30-37.88; p=0.023). Conclusion: these findings underscore the importance of early screening for NAFLD in this population and suggest that tailored nutritional management may be beneficial in addressing obesity-related liver conditions.

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