1 Department of Gastroenterology and Hepatology, University of Missouri Kansas City (Alisa Likhitsup, Jason Dundulis, Hani El-Halawany, Randal Michelson, John H. Helzberg, Rajiv Chhabra).
2 Department of Gastroenterology and Hepatology, Saint Luke's Hospital of Kansas City (Alisa Likhitsup, John H. Helzberg, Rajiv Chhabra).
3 Department of Radiology, University of Missouri Kansas City (Shaya Ansari).
4 Department of Clinical Research, Mid-America Heart Institute St. Luke's Health System (Colleen Hutton).
5 Department of Biostatistics, Mid-America Heart Institute St. Luke's Health System (Kevin Kennedy), Kansas City, MO, USA.
Non-alcoholic fatty liver disease (NAFLD) is common in patients with inflammatory bowel disease(IBD). The purpose of this study was to further examine the prevalence of NAFLD in IBD patients.
We retrospectively reviewed the medical records of IBD patients who visited the emergency department because of abdominal pain between January 2009 and December 2014. These were compared with a group of 70 controls without IBD, matched for age and body mass index (BMI). Computed tomography data were analyzed for the presence or absence of hepatic steatosis. Patient with recent steroid or excessive alcohol use were excluded. Univariate and multivariate analyses were performed.
NAFLD prevalence was 44% (31/70) in the IBD group vs. 16% (11/70) in controls (P<0.001). There was no significant difference between the 2 groups in age, sex distribution, BMI, presence of diabetes, or levels of serum transaminases, serum albumin or platelets. In multivariate analysis, the presence of IBD was independently associated with NAFLD (odds ratio 4.53, 95% confidence interval 2.00-10.26; P=0.002).
The presence of IBD is strongly and independently associated with NAFLD. Systemic inflammation and alteration of the intestinal microbiome have been proposed as mechanisms, but further studies are needed to better elucidate the pathophysiology.