Glassner Kerri, Malaty Hoda M, Abraham Bincy P
*Department of Internal Medicine, Houston Methodist Hospital, Houston, Texas;†Department of Gastroenterology, Baylor College of Medicine, Houston, Texas; and‡Department of Gastroenterology, Houston Methodist Hospital, Houston, Texas.
Inflamm Bowel Dis. 2017 Jun;23(6):998-1003. doi: 10.1097/MIB.0000000000001085.
Nonalcoholic fatty liver disease (NAFLD) has been increasingly identified in patients with inflammatory bowel disease (IBD). We aimed to determine risk factors of NAFLD in patients with IBD.
We examined 3 groups of patients: IBD + NAFLD, IBD only, and NAFLD only. Data on demographics, body mass index, duration of IBD, type of medication use, laboratory data, and metabolic risk factors were collected.
A total of 168 patients between the ages 19 and 82 were evaluated, 56 patients in each group. Patients with IBD + NAFLD were significantly older than IBD only patients 45.0 (±14.1) versus 35.0 (±13), P = 0.007, and their mean body mass index was higher 30.4 (±10.2) versus 25.6 (±6.4); P = 0.002. IBD + NAFLD patients in comparison with IBD only patients had significantly longer duration of IBD (20 [±12.2] versus 10 [±7.7], P = 0.004), had an increased risk of diabetes (16% versus 2%, P = 0.01), and obesity (40% versus 20%, P = 0.02). There were no differences in the mean age or the mean body mass index (32.6 versus 30.4, P = 0.07) between patients with IBD + NAFLD and NAFLD only. More patients were obese in the NAFLD only group compared with the IBD + NAFLD group (59% versus 40%, P = 0.03), had hypertension (55% versus 33%, P = 0.02), hyperlipidemia (53% versus 17.5%, P = 0.0001), and diabetes (40% versus 16%, P = 0.0001).
IBD patients with NAFLD had longer disease duration of IBD and developed NAFLD with fewer metabolic risk factors than patients with NAFLD only. These findings suggest that there may be other factors that contribute to the development of NAFLD in the IBD population.
非酒精性脂肪性肝病(NAFLD)在炎症性肠病(IBD)患者中越来越多地被发现。我们旨在确定IBD患者发生NAFLD的危险因素。
我们检查了3组患者:IBD合并NAFLD组、单纯IBD组和单纯NAFLD组。收集了人口统计学数据、体重指数、IBD病程、用药类型、实验室数据和代谢危险因素。
共评估了168例年龄在19至82岁之间的患者,每组56例。IBD合并NAFLD组患者的年龄显著大于单纯IBD组,分别为45.0(±14.1)岁和35.0(±13)岁,P = 0.007,其平均体重指数也更高,分别为30.4(±10.2)和25.6(±6.4);P = 0.002。与单纯IBD组患者相比,IBD合并NAFLD组患者的IBD病程明显更长(20[±12.2]年对10[±7.7]年,P = 0.004),患糖尿病的风险增加(16%对2%,P = 0.01),肥胖风险增加(40%对20%,P = 0.02)。IBD合并NAFLD组和单纯NAFLD组患者的平均年龄或平均体重指数无差异(32.6对30.4,P = 0.07)。与IBD合并NAFLD组相比,单纯NAFLD组肥胖患者更多(59%对40%,P = 0.03),患有高血压(55%对33%,P = 0.02)、高脂血症(53%对17.5%,P = 0.0001)和糖尿病(40%对16%,P = 0.0001)。
与单纯NAFLD患者相比,合并NAFLD的IBD患者IBD病程更长,发生NAFLD时的代谢危险因素更少。这些发现表明,在IBD人群中,可能存在其他导致NAFLD发生的因素。