Nagata Takahiro, Funakoshi Sadahiro, Morihara Daisuke, Shakado Satoshi, Yokoyama Keiji, Takata Kazuhide, Tanaka Takashi, Fukunaga Atsushi, Yamauchi Ryo, Fukuda Hiromi, Matsuoka Hiroki, Imakiire So, Sakisaka Hideto, Matsuoka Satoshi, Kuno Nobuaki, Abe Koichi, Ishibashi Hideki, Ashizuka Shinya, Hirai Fumihito
Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
Intest Res. 2023 Oct;21(4):471-480. doi: 10.5217/ir.2023.00035. Epub 2023 Aug 11.
BACKGROUND/AIMS: The frequency and details of nonalcoholic fatty liver disease (NAFLD) complications in patients with inflammatory bowel disease (IBD) remain unclear. This study aimed to clarify characteristics of NAFLD in patients with IBD.
We retrospectively identified and enrolled patients with IBD diagnosed with or without NAFLD by undergoing abdominal computed tomography (CT) at our institution between 2005 and 2020. The primary endpoint was the complication rate of NAFLD in patients with IBD. Secondary endpoints were the clinical characteristics of nonobese patients with IBD and comorbid NAFLD and their association with nutritional and inflammatory parameters.
Twenty-one (21.9%) of 96 eligible patients with IBD also had NAFLD. In nonobese patients (defined as patients with a body mass index <25 kg/m2), C-reactive protein (CRP; P<0.001) and alanine aminotransferase (P=0.018) levels were higher and the albumin level (P=0.005) and prognostic nutritional index (PNI; P=0.002) values were lower in patients with NAFLD than in those without NAFLD. The PNI value was positively correlated (P<0.001) and the CRP level was negatively correlated (P=0.001) with the hepatosplenic ratio. However, in the NAFLD combined group, PNI (P<0.05) and CRP values (P<0.001) were improved over time after CT imaging by continuing IBD treatment.
Worsening nutritional and inflammatory status in IBD patients is associated with complications of NAFLD. Diagnosis of NAFLD in IBD patients using CT imaging might be useful not only for early detection of NAFLD but also in assessing the need for therapeutic intervention for IBD.
背景/目的：炎症性肠病（IBD）患者中非酒精性脂肪性肝病（NAFLD）并发症的发生率及细节尚不清楚。本研究旨在阐明IBD患者中NAFLD的特征。
我们回顾性地识别并纳入了2005年至2020年间在我们机构接受腹部计算机断层扫描（CT）诊断为有或无NAFLD的IBD患者。主要终点是IBD患者中NAFLD的并发症发生率。次要终点是IBD合并NAFLD的非肥胖患者的临床特征及其与营养和炎症参数的关联。
96例符合条件的IBD患者中有21例（21.9%）也患有NAFLD。在非肥胖患者（定义为体重指数<25kg/m²的患者）中，NAFLD患者的C反应蛋白（CRP；P<0.001）和丙氨酸转氨酶（P=0.018）水平较高，白蛋白水平（P=0.005）和预后营养指数（PNI；P=0.002）值低于无NAFLD的患者。PNI值与肝脾比呈正相关（P<0.001），CRP水平与肝脾比呈负相关（P=0.001）。然而，在NAFLD合并组中，通过持续进行IBD治疗，CT成像后随时间推移PNI（P<0.05）和CRP值（P<0.001）有所改善。
IBD患者营养和炎症状态的恶化与NAFLD的并发症相关。使用CT成像诊断IBD患者中的NAFLD不仅可能有助于早期发现NAFLD，还可用于评估IBD治疗干预的必要性。
