Liver fibrosis evaluation in patients with psychiatric diseases - 27/06/25
, Morgane Chalange a, d, Murielle Girard e, Aurélie Prémaud c, Mireille Okassa e, Aurélie Lacroix e, Marilyne Debette-Gratien a, b, c, Brigitte Plansont e, Alexandre Buisson e, Benjamin Calvet b, e, Céline Rigaud a, Jérôme Boursier f, Philippe Nubukpo a, b, g, Véronique Loustaud-Ratti a, cHighlights |
• | Patients with chronic psychiatric diseases are exposed to metabolic syndrome and other comorbidities affecting the liver. |
• | We detected advanced fibrosis according to liver stiffness, with a 6 % prevalence in patients with psychiatric disorders receiving psychotropic medications for at least two years. |
• | One-third-of these patients were affected by significant steatosis. |
• | Assessment of liver stiffness may be useful in this population for liver disease screening. |
Abstract |
Introduction: Mental illnesses and psychiatric disorders are public health problems, with an increasing prevalence. Life expectancy of patients is compromised by comorbid somatic illnesses, including liver diseases. Screening for liver fibrosis in this population is challenging.
Materials & Methods: We assessed liver fibrosis using liver stiffness (LS) measurement by FibroScan® in a large cohort of patients with severe psychiatric disorders receiving psychotropic medications for at least two years. Liver steatosis was evaluated using the Controlled Attenuation Parameter™ (CAP).
Results: 355 patients were prospectively included. Advanced fibrosis (LS >8 kPa) prevalence was 6 %. In univariate analysis, advanced fibrosis was associated with high blood pressure (p < 0.001), high ferritin concentration (p = 0.028), and psychotropic drug exposure (p = 0.036). In multivariate analysis, high blood pressure only remained significant (p = 0.002). 34.9 % of patients had significant steatosis (CAP >275 dB/m). In univariate analysis, steatosis was associated with sleep apnea syndrome (p = 0.016), past alcohol dependence (p = 0.013), high body mass index (BMI), type 2 diabetes (p = 0.003), elevated triglycerides (p < 0.001), metabolic syndrome (p < 0.001), metabolic dysfunction-associated liver disease (p < 0.001), and high ferritin concentration (p = 0.008). In multivariable analysis, high BMI and elevated triglycerides remained significant.
Conclusion: Psychiatric patients are at risk of liver fibrosis and steatosis. Systematic screening for liver diseases should be required. Further studies are needed to determine the best strategies for prevention and treatment.
Le texte complet de cet article est disponible en PDF.Keywords : Liver elastometry. Psychiatric diseases. Liver fibrosis. Liver steatosis
Abbreviation : A2M, ALT, AST, BMI, CAP, EASL, FLI, HBV, HCV, HDL cholesterol, HIV, IDF, INR, INSERM, LS, MASLD, MASH, MINI-DSMIV, NASH, RR, STROBE, VCTE
Plan
| Grants. |
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| EchoSens. |
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| Conflict of interest: None. |
Vol 49 - N° 7
Article 102636- juillet 2025 Retour au numéro
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