From gut to liver: Exploring the relationship between inflammatory bowel disease and metabolic dysfunction-associated steatotic liver disease

Table 1 Factors associated with the development of metabolic dysfunction-associated steatotic liver disease in patients with inflammatory bowel disease

Associated factor	Evidence/commentary
Obesity	Observed even in patients with IBD in clinical remission
Insulin resistance	Central mechanism in the pathophysiology of MASLD, aggravated by chronic inflammation
Prolonged use of corticosteroids	Associated with changes in lipid metabolism and fat distribution
Metabolic syndrome	High prevalence in patients with IBD and MASLD
Chronic low-grade inflammation	May contribute to liver changes even with IBD in remission
Intestinal dysbiosis	Affects hepatic homeostasis via the gut–liver axis
Previous malnutrition with rapid refeeding	Can lead to hepatic steatosis due to liver overload
Sedentary lifestyle	Reduced energy expenditure contributes to the accumulation of liver fat
Use of methotrexate or azathioprine	Drugs with potential hepatotoxic impact

IBD: Inflammatory bowel disease; MASLD: Metabolic dysfunction-associated steatotic liver disease.