Screening for nonalcoholic fatty liver disease in inflammatory bowel diseases: A cohort study using transient elastography

Chiara Saroli Palumbo, Sophie Restellini, Che Yung Chao, Achuthan Aruljothy, Carolyne Lemieux, Gary Wild, Waqqas Afif, P. Lakatos, Alain Bitton, Sila Cocciolillo, Peter Ghali, Talat Bessissow, Giada Sebastiani

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13 Citations (Scopus)

Abstract

Background Inflammatory bowel disease (IBD) patients may be at risk for nonalcoholic fatty liver disease (NAFLD) due to chronic inflammation, hepatotoxic drugs, and alteration of the gut microbiota. Prospective data using accurate diagnostic methods are lacking. Methods We prospectively investigated prevalence and predictors of NAFLD and liver fibrosis by transient elastography (TE) with associated controlled attenuation parameter (CAP) in IBD patients as part of a routine screening program. NAFLD was defined as CAP ≥248 dB/m. Significant liver fibrosis (stage 2 or higher out of 4) was defined as TE measurement ≥7.0 kPa. Predictors of NAFLD and significant liver fibrosis were determined by logistic regression analysis. Results A total of 384 patients (mean age 42.4 years, 45.0% male, 64.6% with Crohn's disease) with no significant alcohol intake were included. Prevalence of NAFLD and significant liver fibrosis was 32.8% and 12.2%, respectively. Independent predictors of NAFLD were older age (adjusted odds ratio [aOR], 1.45; 95% confidence interval [CI], 1.15-1.82), higher body mass index (BMI; aOR, 1.31; 95% CI, 1.20-1.42) and higher triglycerides (aOR, 1.45; 95% CI, 1.01-2.09). Significant liver fibrosis was independently predicted by older age (aOR, 1.38; 95% CI, 1.12-1.64) and higher BMI (aOR, 1.14; 95% CI, 1.07-1.23). Extrahepatic diseases were more common in IBD patients with NAFLD compared with those without, namely chronic kidney disease (10.3 vs 2.3%; P < 0.001) and cardiovascular diseases (11.3 vs 4.7%; P = 0.02). Conclusions NAFLD diagnosed by TE with CAP is a frequent comorbidity in IBD patients and is associated with extrahepatic diseases. Noninvasive screening strategies could help early diagnosis and initiation of interventions, including weight loss, correction of dyslipidemia, and linkage to care.

Original languageEnglish
Pages (from-to)124-133
Number of pages10
JournalInflammatory bowel diseases
Volume25
Issue number1
DOIs
Publication statusPublished - Jan 1 2019

Keywords

  • Body mass index
  • controlled attenuation parameter
  • extrahepatic diseases

ASJC Scopus subject areas

  • Immunology and Allergy
  • Gastroenterology

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    Saroli Palumbo, C., Restellini, S., Chao, C. Y., Aruljothy, A., Lemieux, C., Wild, G., Afif, W., Lakatos, P., Bitton, A., Cocciolillo, S., Ghali, P., Bessissow, T., & Sebastiani, G. (2019). Screening for nonalcoholic fatty liver disease in inflammatory bowel diseases: A cohort study using transient elastography. Inflammatory bowel diseases, 25(1), 124-133. https://doi.org/10.1093/ibd/izy200