TY - JOUR
T1 - High prevalence of non-alcoholic fatty liver disease in patients with inflammatory bowel disease receiving anti-tumor necrosis factor therapy
AU - Likhitsup, Alisa
AU - Dundulis, Jason
AU - Ansari, Shaya
AU - Patibandla, Sruthi
AU - Hutton, Colleen
AU - Kennedy, Kevin
AU - Helzberg, John H.
AU - Chhabra, Rajiv
N1 - Funding Information:
aUniversity of Missouri Kansas City (Alisa Likhitsup, Jason Dundulis, Shaya Ansari, Sruthi Patibandla, John H. Helzberg, Rajiv Chhabra); bSaint Luke’s Hospital of Kansas City (Alisa Likhitsup, Jason Dundulis, Shaya Ansari, John H. Helzberg, Rajiv Chhabra); cMid-America Heart Institute St. Luke’s Health System (Colleen Hutton, Kevin Kennedy), Kansas City, MO, USA Conflict of Interest: Dr. John H. Helzberg received research funding from Henry and Marion Bloch Liver Disease Management Fund. Other authors have nothing to disclose
Publisher Copyright:
© 2019 Hellenic Society of Gastroenterology.
PY - 2019/8/25
Y1 - 2019/8/25
N2 - Background Non-alcoholic fatty liver disease (NAFLD) is common in patients with inflammatory bowel disease (IBD). This study evaluated the prevalence of NAFLD and the associated risk factors among IBD patients who received anti-tumor necrosis factor (TNF) therapy. Methods Adult IBD patients receiving anti-TNF therapy (infliximab, adalimumab, certolizumab, golimumab) were enrolled. Hepatic steatosis was assessed by abdominal ultrasound. Patients with a history of excessive alcohol or recent steroid use were excluded. Univariate and multivariate analysis were performed. Results Eighty patients, 55% male, mean age 42±15 years, were enrolled. The sonographic prevalence of NAFLD was 54% (43/80), significantly higher than the general prevalence in the US adult population (30%) (P<0.0001). NAFLD patients had a significantly higher proportion of males, as well as greater body weight and body mass index, compared to non-NAFLD. The Crohns disease activity index (CDAI) was significantly higher among patients with NAFLD. Multivariate analysis demonstrated that a higher CDAI was independently associated with NAFLD, with an odds ratio of 1.6 (95% confidence interval 1.05-2.44; P=0.03). Conclusions The presence of IBD is strongly associated with NAFLD. We identified a high prevalence of NAFLD among IBD patients receiving anti-TNF. CDAI was independently associated with hepatic steatosis. Further studies are still needed to evaluate the pathophysiology of NAFLD development and disease progression among IBD populations.
AB - Background Non-alcoholic fatty liver disease (NAFLD) is common in patients with inflammatory bowel disease (IBD). This study evaluated the prevalence of NAFLD and the associated risk factors among IBD patients who received anti-tumor necrosis factor (TNF) therapy. Methods Adult IBD patients receiving anti-TNF therapy (infliximab, adalimumab, certolizumab, golimumab) were enrolled. Hepatic steatosis was assessed by abdominal ultrasound. Patients with a history of excessive alcohol or recent steroid use were excluded. Univariate and multivariate analysis were performed. Results Eighty patients, 55% male, mean age 42±15 years, were enrolled. The sonographic prevalence of NAFLD was 54% (43/80), significantly higher than the general prevalence in the US adult population (30%) (P<0.0001). NAFLD patients had a significantly higher proportion of males, as well as greater body weight and body mass index, compared to non-NAFLD. The Crohns disease activity index (CDAI) was significantly higher among patients with NAFLD. Multivariate analysis demonstrated that a higher CDAI was independently associated with NAFLD, with an odds ratio of 1.6 (95% confidence interval 1.05-2.44; P=0.03). Conclusions The presence of IBD is strongly associated with NAFLD. We identified a high prevalence of NAFLD among IBD patients receiving anti-TNF. CDAI was independently associated with hepatic steatosis. Further studies are still needed to evaluate the pathophysiology of NAFLD development and disease progression among IBD populations.
KW - Anti-tumor necrosis factor
KW - Hepatic steatosis
KW - Inflammatory bowel disease
KW - Non-alcoholic fatty liver disease
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U2 - 10.20524/aog.2019.0405
DO - 10.20524/aog.2019.0405
M3 - Article
C2 - 31474792
AN - SCOPUS:85071878116
SN - 1108-7471
VL - 32
SP - 463
EP - 468
JO - Annals of Gastroenterology
JF - Annals of Gastroenterology
IS - 5
ER -