Retrospective Cohort Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jan 27, 2018; 10(1): 34-40
Published online Jan 27, 2018. doi: 10.4254/wjh.v10.i1.34
Risk factors for hepatic steatosis in adults with cystic fibrosis: Similarities to non-alcoholic fatty liver disease
Fares Ayoub, Cesar Trillo-Alvarez, Giuseppe Morelli, Jorge Lascano
Fares Ayoub, Department of Medicine, University of Florida, Gainesville, FL 32608, United States
Cesar Trillo-Alvarez, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL 32608, United States
Giuseppe Morelli, Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Florida, Gainesville, FL 32608, United States
Jorge Lascano, Department of Medicine, Adult Cystic Fibrosis Center, Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL 32608, United States
Author contributions: Ayoub F and Morelli G collected the data; Ayoub F analyzed the data; Ayoub F, Morelli G, Lascano J and Trillo-Alvarez C wrote the paper; Trillo-Alvarez C, Morelli G and Lascano J reviewed the paper.
Institutional review board statement: This study was reviewed and approved by the University of Florida Institutional Review Board (IRB201500737).
Informed consent statement: This was a retrospective review, the institutional review board provided a waiver of informed consent since no identifiable patient information would be collected or shared.
Conflict-of-interest statement: The authors declare no conflicts of interest related to this work.
Data sharing statement: Technical appendix, statistical code and datasets are available from the corresponding author at fares.ayoub@medicine.ufl.edu. No additional data are available other than what is included in the article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Fares Ayoub, MD, Department of Medicine, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32608, United States. fares.ayoub@medicine.ufl.edu
Telephone: +1-352-2650239
Received: October 21, 2017
Peer-review started: October 24, 2017
First decision: November 23, 2017
Revised: December 6, 2017
Accepted: December 13, 2017
Article in press: December 13, 2017
Published online: January 27, 2018
ARTICLE HIGHLIGHTS
Research background

Hepatic steatosis is increasingly recognized in patients with cystic fibrosis (CF) on imaging. Patients often do not demonstrate associated laboratory abnormalities or abnormal physical findings. Whether hepatic steatosis represents a manifestation of classic CF liver disease is unknown. The risk factors for such a manifestation are also unknown.

Research motivation

To describe the clinical characteristics of CF patients with hepatic steatosis and to describe risk factors for the condition as compared to patients with hepatic steatosis.

Research methods

A retrospective cohort study compares cases with hepatic steatosis to controls.

Research results

Our study demonstrates that CF patients with hepatic steatosis demonstrate a higher body mass index (BMI) as well as improved pulmonary function reflected by higher forced expiratory volume as compared to normal controls. These findings indicate that patients with hepatic steatosis were relatively healthier and had an improved nutritional status as compared to controls.

Research conclusions

To our knowledge, this study is the first retrospective study dedicated to characterizing hepatic steatosis in adults with CF. The authors found patients with hepatic steatosis to have a higher body mass index as well as better pulmonary function. The authors did not find any patients with frank liver disease. The findings indicate similarities to non-alcoholic fatty liver disease. Whether this finding evolves into cirrhosis will need to be determined with longer prospective studies.

Research perspectives

CF patients with hepatic steatosis should be followed closely to determine the evolution of their disease. Caution should be exercised by providers since this lesion may exhibit similarity to non-alcoholic fatty liver disease which is now known to progress to cirrhosis in a sub-set of patients. Future, long-term prospective studies of CF patients with hepatic steatosis are needed to identify how frequently patients progress to cirrhosis.