Liver and Bile

Clin Gastroenterol Hepatol. 2023;21(2):406–14.e7

Rodriguez-Duque JC, Calleja JL, Iruzubieta P, Hernández-Conde M, Rivas-Rivas C, Vera MI, Garcia MJ, Pascual M, Castro B, García-Blanco A, García-Nieto E, Curiel-del Olmo S, Cagigal ML, Lopez-Montejo L, Fernández-Lamas T, Rasines L, Fortea JI, Vaque JP, Frias Y, Rivero M, Arias-Loste MT, Crespo J

Increased risk of MAFLD and liver fibrosis in inflammatory bowel disease independent of classic metabolic risk factors

Background and aims: There is conflicting evidence regarding the prevalence of and risk factors for metabolic-associated fatty liver disease (MAFLD) in patients with inflammatory bowel disease (IBD). The authors aimed to determine MAFLD prevalence and risk factors in IBD patients.
Methods: The cross-sectional, case-control study included all consecutive IBD patients treated at 2 different university hospitals. Controls were subjects randomly selected from the general population and matched by age, sex, type 2 diabetes status, and body mass index in a 1:2 ratio. MAFLD was confirmed by controlled attenuation parameter. Liver biopsies were collected when MAFLD with significant liver fibrosis was suspected. In addition, age- and fibrosis stage-paired non-IBD patients with biopsy-proven MAFLD served as a secondary control group.
Results: 831 IBD patients and 1718 controls were included. The prevalence of MAFLD and advanced liver fibrosis (transient elastography ≥ 9.7 kPa) was 42.00% and 9.50%, respectively, in IBD patients and 32.77% and 2.31%, respectively, in the general population (p < 0.001). A diagnosis of IBD was an independent predictor of MAFLD (adjusted odds ratio [aOR] = 1.99; p < 0.001) and an independent risk factor for advanced liver fibrosis (aOR = 5.55; p < 0.001). Liver biopsies were obtained from 40 IBD patients; MAFLD was confirmed in all cases, and fibrosis of any degree was confirmed in 25 of 40 cases (62.5%). Body mass index and type 2 diabetes prevalence were significantly lower in IBD-MAFLD patients than in severity-paired patients with biopsy-proven MAFLD.

Conclusions: Metabolic-associated fatty liver disease and liver fibrosis are particularly prevalent in patients with inflammatory bowel disease, regardless of the influence of classic metabolic risk factors.

Prof. Dr. M.T. Arias-Loste and Prof. Dr. J. Crespo, Servicio de Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Santander, Spain,



DOI: DOI: 10.1016/j.cgh.2022.01.039

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