Interview IHU ICAN x Ifop – Dr Raluca Pais, hepato-gastroenterologist at AP-HP, shares her analysis of the results of the 3ᵉ edition of the cardiometabolism barometer
The study reveals that only 30% of French people are familiar with the term “cardiometabolic diseases”, despite the fact that they affect millions of people in France. How do you interpret this still limited level of knowledge, and what levers do you see as priorities for improving public understanding?
The data from the3rd edition of the IHU ICAN barometer confirm a worrying gap between medical reality and collective perception. Cardiometabolic diseases remain a blind spot for the French, even though they concern us all. Every year, diabetes, obesity, hypertension, dyslipidemia and metabolic steatosis of the liver are responsible for numerous serious cardiovascular complications, leading to emergency hospitalization and, all too often, death.
Cardiometabolic diseases are now a majorpublichealthissue, requiring a coordinated response combining prevention, early diagnosis and personalized care.
Metabolic steatosis of the liver illustrates the gap between prevalence and knowledge. Among French people who say they know about cardiometabolic diseases, only 3% spontaneously identify it as belonging to this family of pathologies?
Yet this is an extremely common disease: it affects almost 1 in 5 adults in France, and can have very serious consequences. Completely silent, it can progress to chronic inflammation of the liver (MASH), cirrhosis and, in 10-20% of cases, liver cancer. According to the Agence de la biomédecine, hepatic metabolic steatosis is now one of the leading causes of liver transplantation in France and other Western countries. This disease, closely linked to diabetes, obesity and a sedentary lifestyle, is emblematic of the dialogue between organs, and in particular the heart/liver dialogue.
It is essential to inform the French about its possible complications – chronic inflammation of the liver, cirrhosis, even cancer – in order to encourage early detection and appropriate treatment before it leads to irreversible complications.
An evaluation carried out among patients at the MASH clinic (AP-HP/IHU ICAN) showed that among patients followed up with steatosis and no known cardiovascular disease at the time of treatment, 30% had a high cardiovascular risk discovered thanks to systematic screening using the coronary calcium score set up as part of the MASH clinic’s personalized care pathway.
How is the ICAN IHU positioning itself to combat the progression of metabolic steatosis of the liver (MASH), which now affects 30% of the world’s population?
In 2019, the AP-HP and the IHU ICAN set up the 1st hospital-based structure for the diagnosis and multidisciplinary management of patients with metabolic steatosis in France: the MASH clinic, located on the Pitié-Salpêtrière Hospital site in Paris. Its aim is to optimize the diagnosis and management of patients suffering from hepatic steatosis, to better control their disease, and to slow or even halt its progression to severe forms. In a single day, patients undergo all the examinations required to diagnose their condition and assess their personal risk of progressing to more severe forms or developing other pathologies : liver exploration to assess the severity of liver damage, cardiovascular exploration – coronary calcium score to identify early atherosclerotic lesions, and metabolic exploration to assess the risk of developing type 2 diabetes and metabolic comorbidities.over 600 patients have already benefited.
To better understand MASH and provide lasting solutions, the ICAN IHU is also conducting dedicated research projects, including the establishment of a patient cohort to better identify and understand the factors responsible for disease progression.
Further information on the MASH clinic: https: //ihuican.org/clinique-nash-2/
