Published online Jan 27, 2018. doi: 10.4254/wjh.v10.i1.34
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
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.
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.
A retrospective cohort study compares cases with hepatic steatosis to controls.
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.
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.
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.