Martínez-Domínguez Samuel J, García-Mateo Sandra, Gargallo-Puyuelo Carla J, Gallego-Llera Beatriz, Callau Pilar, Mendi Carolina, Arroyo-Villarino María Teresa, Simón-Marco Miguel Ángel, Ampuero Javier, Gomollón Fernando
Department of Gastroenterology, Lozano Blesa University Hospital, Zaragoza, Spain.
Digestive Pathology Translational Research Group, Aragón Health Research Institute, Zaragoza, Spain.
Inflamm Bowel Dis. 2024 Aug 1;30(8):1274-1283. doi: 10.1093/ibd/izad175.
Despite classical association between metabolic dysfunction-associated steatotic liver disease (MASLD) and obesity, there is increasing evidence on the development of MASLD in lean individuals. The aim of the study was to assess the prevalence and risk factors of MASLD and significant liver fibrosis in lean participants with inflammatory bowel disease (IBD).
This was a cross-sectional, case-control study including 300 lean cases with IBD and 80 lean controls without IBD, matched by sex and age. All participants underwent a liver ultrasound, transient elastography, and laboratory tests.
The lean IBD group showed a significantly higher prevalence of MASLD compared with lean non-IBD group (21.3% vs 10%; P = .022), but no differences were observed in the prevalence of significant liver fibrosis (4.7% vs 0.0%; P = 1.000). No differences were found between the prevalence of MASLD in IBD and non-IBD participants who were overweight/obese (66.8% vs 70.8%; P = .442). In addition, the prevalence of MASLD was significantly higher in the overweight/obese IBD group compared with the lean IBD group (P < .001). IBD was an independent risk factor for MASLD in lean participants (odds ratio [OR], 2.71; 95% confidence interval [CI], 1.05-7.01; P = .04), after adjusting for classic metabolic risk factors and prior history of systemic steroid use. Nevertheless, no association between IBD related factors and MASLD was identified in lean IBD participants. When the overweight/obese and lean IBD groups with MASLD were compared, the overweight/obese IBD group with MASLD showed higher levels of the homeostatic model assessment of insulin resistance (OR, 1.49; 95% CI, 1.11-1.98; P = .007) and history of smoking (OR, 4.66; 95% CI, 1.17-18.49; P = .029).
MASLD prevalence was higher in the lean IBD group compared with lean non-IBD group, independent of classic metabolic risk factors.
尽管代谢功能障碍相关脂肪性肝病（MASLD）与肥胖之间存在经典关联，但越来越多的证据表明瘦人也会发生MASLD。本研究旨在评估炎症性肠病（IBD）瘦人参与者中MASLD和显著肝纤维化的患病率及危险因素。
这是一项横断面病例对照研究，纳入300例IBD瘦人病例和80例无IBD的瘦人对照，按性别和年龄匹配。所有参与者均接受肝脏超声、瞬时弹性成像和实验室检查。
与非IBD瘦人组相比，IBD瘦人组MASLD患病率显著更高（21.3%对10%；P = 0.022），但在显著肝纤维化患病率方面未观察到差异（4.7%对0.0%；P = 1.000）。IBD和非IBD超重/肥胖参与者的MASLD患病率无差异（66.8%对70.8%；P = 0.442）。此外，超重/肥胖IBD组的MASLD患病率显著高于IBD瘦人组（P < 0.001）。在调整经典代谢危险因素和全身使用类固醇的既往史后，IBD是瘦人参与者发生MASLD的独立危险因素（比值比[OR]，2.71；95%置信区间[CI]，1.05 - 7.01；P = 0.04）。然而，在IBD瘦人参与者中未发现IBD相关因素与MASLD之间存在关联。比较有MASLD的超重/肥胖IBD组和IBD瘦人组时，有MASLD的超重/肥胖IBD组胰岛素抵抗稳态模型评估水平更高（OR，1.49；95% CI，1.11 - 1.98；P = 0.007）且吸烟史更多（OR，4.66；95% CI，1.17 - 18.49；P = 0.029）。
与非IBD瘦人组相比，IBD瘦人组MASLD患病率更高，且独立于经典代谢危险因素。
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