Frezet Sarah, Hermabessière Paul, Kerlogot Laurianne, Wilsius Eva, Balde Coraline, Pellet Gauthier, Chevrier Constance, Castinel Jean, de Ledinghen Victor, Poullenot Florian
Gastroenterology Department, CHU de Bordeaux, Centre Medico-chirurgical Magellan, Hôpital Haut-Lévêque, Université de Bordeaux, Bordeaux, France.
BRIC, INSERM U1312, Université de Bordeaux, Bordeaux, France.
JPEN J Parenter Enteral Nutr. 2025 May;49(4):507-516. doi: 10.1002/jpen.2746. Epub 2025 Mar 16.
Intestinal failure-associated liver disease (IFALD) is a major complication of chronic intestinal failure. Few data exist about hepatic monitoring of IFALD using the liver stiffness measurement. The aim of this study was to provide a descriptive analysis of IFALD and its prevalence in a tertiary center and to determine the IFALD risk factors and high liver stiffness measurement values using FibroScan.
Adult patients with chronic intestinal failure treated with home parenteral nutrition and followed in a tertiary center with no underlying liver disease and at least one liver stiffness measurement record were included between January 1, 2007, and June 6, 2023.
Eighty-nine patients were included from this cohort of 145 patients. The prevalence of IFALD was 34%. A total of 14% had a liver stiffness measurement >10 kPa, and 49% had a liver stiffness measurement <5 kPa. In multivariate analysis, IFALD was positively associated with the use of a customized admixture (odds ratio [OR] = 7.04; 95% CI, 1.44-43.64; P = 0.017) and negatively associated with the colon in continuity (OR = 0.25; 95% CI, 0.07-0.87; P = 0.029). No significant association was observed between liver stiffness measurement values and IFALD.
The prevalence of IFALD was low in our study. Absence of the colon and the use of a customized admixture were risk factors for IFALD. Liver stiffness measurement was abnormal in 51% of cases. A long-term follow-up of this cohort will help to assess the prognostic relevance of IFALD and liver stiffness measurement in these patients.
肠衰竭相关肝病（IFALD）是慢性肠衰竭的主要并发症。关于使用肝脏硬度测量法对IFALD进行肝脏监测的数据较少。本研究的目的是对一家三级中心的IFALD及其患病率进行描述性分析，并使用FibroScan确定IFALD的危险因素和高肝脏硬度测量值。
纳入2007年1月1日至2023年6月6日期间在一家三级中心接受家庭肠外营养治疗的成年慢性肠衰竭患者，这些患者无潜在肝脏疾病且至少有一次肝脏硬度测量记录。
该队列的145例患者中，89例被纳入研究。IFALD的患病率为34%。共有14%的患者肝脏硬度测量值>10 kPa，49%的患者肝脏硬度测量值<5 kPa。在多变量分析中，IFALD与使用定制混合液呈正相关（比值比[OR]=7.04；95%置信区间，1.44 - 43.64；P = 0.017），与连续性结肠呈负相关（OR = 0.25；95%置信区间，0.07 - 0.87；P = 0.029）。未观察到肝脏硬度测量值与IFALD之间存在显著关联。
在我们的研究中，IFALD的患病率较低。结肠缺失和使用定制混合液是IFALD的危险因素。51%的病例肝脏硬度测量异常。对该队列进行长期随访将有助于评估IFALD和肝脏硬度测量对这些患者的预后相关性。
