Section of Gastroenterology, Department of Emergency and Organ Transplantation, AOU Policlinico, University of Bari, Italy.
National Institute of Gastroenterology, "S De Bellis" Research Hospital, Castellana Grotte, Italy.
Inflamm Bowel Dis. 2018 Jun 8;24(7):1589-1596. doi: 10.1093/ibd/izy051.
Nonalcoholic fatty liver disease (NAFLD) is common in inflammatory bowel diseases (IBD). Herein, NAFLD prevalence and risk factors in a large IBD cohort were evaluated and compared to that of a non-IBD sample.
Crohn's disease/ulcerative colitis outpatients referred to IBD service of our Gastroenterology Unit were enrolled. Subjects affected by functional and motor gastrointestinal disorders, in whom IBD was ruled out, referred to general outpatient service in the same area, were considered as nonIBD group. Exclusion criteria were based on previous diagnosis of nonNAFLD chronic liver diseases and secondary causes of fat liver overload. Characteristics of IBD and liver status were collected. Risk factors for metabolic syndrome were analyzed. Ultrasonographic presence and degree of steatosis were assessed. Data were examined by univariate and multivariate analyses.
For this study 465 IBD and 189 non-IBD subjects were consecutively enrolled. NAFLD was found in 28.0% and 20.1% in IBD and non-IBD subjects, respectively (P = 0.04). IBD patients with NAFLD were younger than non-IBD ones. There was no significant difference in steatosis grade and association between NAFLD and IBD behavior, extension, activity, and drugs. In the IBD group, multivariate analysis demonstrated that NAFLD was independently associated to metabolic syndrome (OR=2.24, 95%CI 1.77-28.81), diabetes (OR=1.71, 95%CI 1.43-12.25), fasting blood glucose (OR=1.36, 95%CI 1.13-1.68), and abdominal circumference (OR=1.68, 95%CI 1.15-14.52).
NAFLD is more common and occurs at a younger age in IBD than in nonIBD subjects. However, further investigation is required to ascertain possible NAFLD pathogenic IBD-related factors other than conventional/metabolic ones. 10.1093/ibd/izy051_video1izy051.video15774874877001.
非酒精性脂肪性肝病（NAFLD）在炎症性肠病（IBD）中很常见。在此，评估并比较了大型 IBD 队列中的 NAFLD 患病率和危险因素，以及非 IBD 样本中的患病率和危险因素。
招募了我院消化科 IBD 门诊的克罗恩病/溃疡性结肠炎患者。受功能性和动力性胃肠道疾病影响的患者，IBD 已排除在外，在同一地区的普通门诊就诊，被认为是非 IBD 组。排除标准基于先前诊断为非 NAFLD 慢性肝病和继发性脂肪肝过载的原因。收集了 IBD 和肝脏状况的特征。分析了代谢综合征的危险因素。评估了超声存在和脂肪变性程度。通过单变量和多变量分析检查数据。
本研究共纳入 465 例 IBD 和 189 例非 IBD 患者。IBD 和非 IBD 患者的 NAFLD 发生率分别为 28.0%和 20.1%（P = 0.04）。患有 NAFLD 的 IBD 患者比非 IBD 患者年轻。NAFLD 与 IBD 行为、延伸、活动和药物之间的严重程度无显著差异。在 IBD 组中，多变量分析表明，NAFLD 与代谢综合征（OR=2.24，95%CI 1.77-28.81）、糖尿病（OR=1.71，95%CI 1.43-12.25）、空腹血糖（OR=1.36，95%CI 1.13-1.68）和腰围（OR=1.68，95%CI 1.15-14.52）独立相关。
与非 IBD 患者相比，IBD 患者中 NAFLD 更为常见，且发病年龄更小。然而，需要进一步的研究来确定除了传统/代谢因素之外，可能与 IBD 相关的 NAFLD 发病机制因素。
