Screening for Nonalcoholic Fatty Liver Disease in Inflammatory Bowel Diseases: A Cohort Study Using Transient Elastography

Autor: Waqqas Afif, Chiara Saroli Palumbo, Alain Bitton, Carolyne Lemieux, Che-Yung Chao, Peter Ghali, Sila Cocciolillo, Sophie Restellini, Gary Wild, Giada Sebastiani, Peter L. Lakatos, Achuthan Aruljothy, Talat Bessissow
Rok vydání: 2018
Předmět:
Adult
Male
0301 basic medicine
medicine.medical_specialty
Elasticity Imaging Techniques/methods
Comorbidity
digestive system
Gastroenterology
Inflammatory bowel disease
Body Mass Index
03 medical and health sciences
0302 clinical medicine
Inflammatory Bowel Diseases/complications/therapy
Risk Factors
Internal medicine
Nonalcoholic fatty liver disease
medicine
Humans
Mass Screening
Immunology and Allergy
Prospective Studies
Mass screening
ddc:616
business.industry
Incidence
digestive
oral
and skin physiology
Odds ratio
Middle Aged
Prognosis
medicine.disease
digestive system diseases
Cross-Sectional Studies
030104 developmental biology
Non-alcoholic Fatty Liver Disease/diagnosis/diagnostic imaging/epidemiology/etiology
Female
030211 gastroenterology & hepatology
Transient elastography
business
Body mass index
Follow-Up Studies
Kidney disease
Zdroj: Inflammatory Bowel Diseases, Vol. 25, No 1 (2019) pp. 124-133
ISSN: 1536-4844
1078-0998
DOI: 10.1093/ibd/izy200
Popis: Background Inflammatory bowel disease (IBD) patients may be at risk for nonalcoholic fatty liver disease (NAFLD) due to chronic inflammation, hepatotoxic drugs, and alteration of the gut microbiota. Prospective data using accurate diagnostic methods are lacking. Methods We prospectively investigated prevalence and predictors of NAFLD and liver fibrosis by transient elastography (TE) with associated controlled attenuation parameter (CAP) in IBD patients as part of a routine screening program. NAFLD was defined as CAP ≥248 dB/m. Significant liver fibrosis (stage 2 or higher out of 4) was defined as TE measurement ≥7.0 kPa. Predictors of NAFLD and significant liver fibrosis were determined by logistic regression analysis. Results A total of 384 patients (mean age 42.4 years, 45.0% male, 64.6% with Crohn's disease) with no significant alcohol intake were included. Prevalence of NAFLD and significant liver fibrosis was 32.8% and 12.2%, respectively. Independent predictors of NAFLD were older age (adjusted odds ratio [aOR], 1.45; 95% confidence interval [CI], 1.15-1.82), higher body mass index (BMI; aOR, 1.31; 95% CI, 1.20-1.42) and higher triglycerides (aOR, 1.45; 95% CI, 1.01-2.09). Significant liver fibrosis was independently predicted by older age (aOR, 1.38; 95% CI, 1.12-1.64) and higher BMI (aOR, 1.14; 95% CI, 1.07-1.23). Extrahepatic diseases were more common in IBD patients with NAFLD compared with those without, namely chronic kidney disease (10.3 vs 2.3%; P < 0.001) and cardiovascular diseases (11.3 vs 4.7%; P = 0.02). Conclusions NAFLD diagnosed by TE with CAP is a frequent comorbidity in IBD patients and is associated with extrahepatic diseases. Noninvasive screening strategies could help early diagnosis and initiation of interventions, including weight loss, correction of dyslipidemia, and linkage to care. 10.1093/ibd/izy200_video1izy200.video15794817619001.
Databáze: OpenAIRE
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