Published online Dec 14, 2020. doi: 10.3748/wjg.v26.i46.7367
Peer-review started: October 12, 2020
First decision: October 27, 2020
Revised: November 3, 2020
Accepted: November 21, 2020
Article in press: November 21, 2020
Published online: December 14, 2020
Nonalcoholic fatty liver disease (NAFLD) is common in the German population, with an even higher prevalence in inflammatory bowel disease patients.
Finding reasons for the high prevalence of NAFLD in inflammatory bowel disease patients.
Identifying risk factors for NAFLD in inflammatory bowel disease patients.
Analysis of abdominal ultrasound examinations of inflammatory bowel disease patients and electronically available data was performed. Demographic characteristics, disease activity and medications were analyzed as potential risk factors in a cross-sectional design. Parameters influencing the course of NAFLD were identified by a generalized linear mixed model.
Forty-eight percent of Crohn’s disease (CD) patients and 44% of ulcerative colitis patients suffered from NAFLD. Its occurrence was associated with greater age, hypertension and body mass index (BMI) in both groups, and with higher disease activity and dyslipidemia in CD. 2467 ultrasound results were included in the longitudinal analysis. Risk factors for NAFLD were age, BMI, higher disease activity, bowel resection(s), endoscopic activity and azathioprine use in CD; and BMI and endoscopic activity in ulcerative colitis.
This study shows that NAFLD is highly prevalent in a cohort of German inflammatory bowel disease patients. Its risk increased mainly with rising age and BMI. The analysis provides a rationale for non-invasive liver screening in inflammatory bowel disease patients.
A randomized controlled prospective study is required to further verify the discovered risk factors.