TITLE:
Non-Invasive Assessment of Liver Fibrosis Using the FIB-4 Score in Patients with Hepatic Steatosis at Libreville University Hospital
AUTHORS:
Agnès Angela Engoang, Nesta Patricia Ziza Ngaila, Patrice Emery Itoudi Bignoumba, Patrick Dieudonné Nzouto, Pegguy Biloghe, Treycia Pambo, Eudine Tsiouka, Jean Baptiste Moussavou Kombila
KEYWORDS:
Hepatic Steatosis, Liver Fibrosis, FIB-4 Score, Metabolic Syndrome, Gabon
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.16 No.10,
October
21,
2026
ABSTRACT: Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) has become the leading cause of chronic liver disease worldwide, carrying a risk of progression to fibrosis, cirrhosis, and hepatocellular carcinoma. The FIB-4 score, simple and inexpensive, is recommended as a first-line non-invasive tool for fibrosis screening. This study aimed to describe the epidemiological and clinical profile of patients with hepatic steatosis and to assess fibrosis stage using the FIB-4 score at Libreville University Hospital (CHUL). Patients and Methods: This was a prospective, descriptive and analytical study of 124 patients followed from January 2025 to June 2026 in the Department of Hepato-Gastroenterology and Digestive Endoscopy at CHUL. Sociodemographic, clinical, biological and ultrasonographic data were collected, along with the FIB-4 score, calculated using the Sterling et al. formula. Comparisons used the Chi-square and Mann-Whitney tests, with correlation assessed by Spearman’s coefficient (significance threshold p Results: Mean age was 51.6 ± 10.8 years, with a female predominance (sex ratio = 1.38). All patients presented with ultrasonographic hepatic steatosis. The main risk factors were a fat-rich diet (80.6%), sedentary lifestyle (57.3%), diabetes (46.8%) and metabolic syndrome (39.5%). Hepatitis B surface antigen carriage was noted in 17.7% of patients, and 43.5% of patients had at least one condition (chronic hepatitis B or C, cirrhosis, or portal hypertension) that could independently affect FIB-4 components. Mean FIB-4 score was 1.56 ± 0.84; 45.2% of patients had a low score (2.67), positively correlated with age (r = 0.34; p Conclusion: Hepatic steatosis and its metabolic risk factors are common in this Gabonese hospital population, supporting systematic non-invasive screening with FIB-4 and wider access to confirmatory diagnostic tools.