Hsiao Shun-Wen, Chen Ting-Chun, Su Pei-Yuan, Yang Chen-Ta, Huang Siou-Ping, Chen Yang-Yuan, Yen Hsu-Heng
Division of Gastroenterology, Changhua Christian Hospital, Changhua 500, Taiwan.
Division of Endocrinology and Metabolism, Cheng Ching Hospital, Taichung 400, Taiwan.
Diagnostics (Basel). 2023 Oct 20;13(20):3268. doi: 10.3390/diagnostics13203268.
The prevalence of inflammatory bowel disease (IBD) has increased worldwide. The prevalence of metabolic dysfunction associated fatty liver disease (MAFLD) has also risen. However, there is limited research on the connection between MAFLD and IBD in the Asian population. This study aims to analyze the prevalence and clinical significance of MAFLD in Taiwanese IBD patients with clinical remission. We retrospectively analyzed IBD patients who received transient elastography for liver fibrosis and controlled attenuation parameter evaluation for liver steatosis. This study enrolled 120 patients with IBD, including 45 Crohn's disease (CD) and 75 ulcerative colitis (UC). MAFLD prevalence in IBD was 29.2%. Patients with MAFLD had a shorter disease duration (2.8 years vs. 5.3 years, = 0.017), higher alanine aminotransferase levels (24 U/L vs. 17 U/L, = 0.003), a lower estimated glomerular filtration rate (91.37 mL/min/1.73 m vs. 103.92 mL/min/1.73 m, = 0.004), and higher γ-glutamyl transferase (γ-GT) (24 mg/dL vs. 13 mg/dL, < 0.001). The prevalence of significant fibrosis in IBD with MAFLD was 17.1%. Significant fibrosis was found in older age (58.5 years vs. 40 years, = 0.004) and the high type 2 diabetes mellitus proportion (50.0% vs. 10.3%, = 0.049). A trend of longer disease duration was found in significant fibrosis (4.9 years vs. 1.6 years, = 0.051). The prevalence of MALFD in IBD was 29.2%. and 17.1% of them had significant fibrosis. In addition to the intestinal manifestation, the study findings remind clinicians that they should be aware of the possibility of hepatic complications for IBD patients.
炎症性肠病（IBD）在全球范围内的患病率呈上升趋势。代谢功能障碍相关脂肪性肝病（MAFLD）的患病率也有所上升。然而，在亚洲人群中，关于MAFLD与IBD之间联系的研究有限。本研究旨在分析台湾临床缓解期IBD患者中MAFLD的患病率及其临床意义。我们回顾性分析了接受瞬时弹性成像评估肝纤维化以及受控衰减参数评估肝脂肪变性的IBD患者。本研究纳入了120例IBD患者，其中45例为克罗恩病（CD），75例为溃疡性结肠炎（UC）。IBD患者中MAFLD的患病率为29.2%。MAFLD患者的病程较短（2.8年对5.3年，P = 0.017），丙氨酸氨基转移酶水平较高（24 U/L对17 U/L，P = 0.003），估计肾小球滤过率较低（91.37 mL/min/1.73 m²对103.92 mL/min/1.73 m²，P = 0.004），γ-谷氨酰转移酶（γ-GT）较高（24 mg/dL对13 mg/dL，P < 0.001）。IBD合并MAFLD患者中显著肝纤维化的患病率为17.1%。显著肝纤维化在年龄较大者（58.5岁对40岁，P = 0.004）以及2型糖尿病比例较高者中更为常见（50.0%对10.3%，P = 0.049）。在显著肝纤维化患者中发现病程有延长趋势（4.9年对1.6年，P = 0.051）。IBD患者中MALFD的患病率为29.2%，其中17.1%有显著肝纤维化。除肠道表现外，本研究结果提醒临床医生应意识到IBD患者发生肝脏并发症的可能性。
