Department of Medical Sciences and Public Health, University of Cagliari, Monserrato 09042, Italy.
Department of Systems Medicine, University of Rome "Tor Vergata", Rome 00133, Italy.
World J Gastroenterol. 2019 Oct 7;25(37):5676-5686. doi: 10.3748/wjg.v25.i37.5676.
Nonalcoholic fatty liver disease (NAFLD) is a frequently reported condition in patients with inflammatory bowel disease (IBD). Both intestinal inflammation and metabolic factors are believed to contribute to the pathogenesis of IBD-associated NAFLD.
To evaluate the prevalence of steatosis and liver fibrosis (LF) in a cohort of IBD patients and the identification of metabolic- and IBD-related risk factors for NAFLD and LF.
IBD patients were consecutively enrolled from December 2016 to January 2018. Demographic, anthropometric and biochemical data were collected so as eating habits. Abdominal ultrasound and transient elastography were performed to evaluate the presence of NAFLD and LF respectively.
A total of 178 consecutive patients were enrolled and included in the analysis (95 Ulcerative colitis, 83 Crohn's disease). NAFLD was detected by imaging in 72 (40.4%) patients. Comparison between patients with and without NAFLD showed no significant differences in terms of IBD severity, disease duration, location/extension, use of IBD-related medications (., steroids, anti-TNFs, and immunomodulators) and surgery. NAFLD was significantly associated with the presence of metabolic syndrome [MetS; odds ratio (OR): 4.13, = 0.001] and obesity defined by body mass index (OR: 9.21, = 0.0002). IBD patients with NAFLD showed higher caloric intake and lipid consumption than those without NAFLD, regardless disease activity. At the multivariate analysis, male sex, advanced age and high lipid consumption were independent risk factors for the development of NAFLD. An increased liver stiffness was detected in 21 patients (16%) and the presence of MetS was the only relevant factor associated to LF (OR: 3.40, = 0.01).
In this study, we demonstrate that risk factors for NAFLD and LF in the IBD population do not differ from those in the general population.
非酒精性脂肪性肝病（NAFLD）是炎症性肠病（IBD）患者常报告的一种病症。肠道炎症和代谢因素都被认为是导致 IBD 相关 NAFLD 发病机制的原因。
评估 IBD 患者队列中脂肪变性和肝纤维化（LF）的患病率，并确定与代谢和 IBD 相关的 NAFLD 和 LF 的危险因素。
我们于 2016 年 12 月至 2018 年 1 月连续招募 IBD 患者。收集人口统计学、人体测量学和生化数据以及饮食习惯。进行腹部超声和瞬时弹性成像分别评估 NAFLD 和 LF 的存在情况。
共纳入并分析了 178 例连续患者（溃疡性结肠炎 95 例，克罗恩病 83 例）。通过影像学检查发现 72 例（40.4%）患者存在 NAFLD。比较有和无 NAFLD 的患者，IBD 严重程度、疾病持续时间、部位/延伸、IBD 相关药物（例如，皮质类固醇、抗 TNFs 和免疫调节剂）和手术的使用方面无显著差异。NAFLD 与代谢综合征（MetS）的存在显著相关[比值比（OR）：4.13， = 0.001]和肥胖定义的体重指数（OR：9.21， = 0.0002）。无论疾病活动度如何，患有 NAFLD 的 IBD 患者的热量摄入和脂质消耗均高于无 NAFLD 的患者。在多变量分析中，男性、高龄和高脂质消耗是 NAFLD 发生的独立危险因素。21 例患者（16%）检测到肝硬度增加，MetS 是唯一与 LF 相关的因素（OR：3.40， = 0.01）。
在这项研究中，我们证明了 IBD 人群中 NAFLD 和 LF 的危险因素与普通人群中的危险因素没有差异。
