Gut Liver.  2024 Mar;18(2):294-304. 10.5009/gnl220409.

Hepatic Steatosis but Not Fibrosis Is Independently Associated with Poor Outcomes in Patients with Inflammatory Bowel Disease

• Hyun HK
• Lee HW
• Park J
• Park SJ
• Park JJ
• Kim TI
• Lee JS
• Kim BK
• Park JY
• Kim DY
• Ahn SH
• Kim SU
• Cheon JH

• KMID: 2553838
• DOI: http://doi.org/10.5009/gnl220409

Abstract

Background/Aims
Increased prevalence of nonalcoholic fatty liver disease (NAFLD) and inflammatory bowel disease (IBD) has been reported. However, the effects of NAFLD on the outcome of IBD remains unclear. We investigated whether the presence of NAFLD could influence the outcomes of patients with IBD.
Methods
We recruited 3,356 eligible patients with IBD into our study between November 2005 and November 2020. Hepatic steatosis and fibrosis were diagnosed using hepatic steatosis index of ≥30 and fibrosis-4 of ≥1.45, respectively. The primary outcome was clinical relapse, defined based on the following: IBD-related admission, surgery, or first use of corticosteroids, immunomodulators, or biologic agents for IBD.
Results
The prevalence of NAFLD in patients with IBD was 16.7%. Patients with hepatic ste-atosis and advanced fibrosis were older, had a higher body mass index, and were more likely to have diabetes (all p<0.05).
Conclusions
Hepatic steatosis was independently associated with increased risks of clinical relapse in patients with ulcerative colitis and Crohn’s disease, whereas fibrotic burden in the liver was not. Future studies should investigate whether assessment and therapeutic intervention for NAFLD will improve the clinical outcomes of patients with IBD.

Keyword

Inflammatory bowel diseases; Non-alcoholic fatty liver disease; Hepatic steatosis; Liver fibrosis; Outcome