İnflamatuar Bağırsak Hastalığı Olan Hastalarda Nonalkolik Yağlı Karaciğer Hastalığının Sıklığı ve Risk Faktörleri

Öz

Aim The aim of this study was to investigate the frequency of Nonalcoholic Fatty Liver Disease (NAFLD) in patients with Inflammatory Bowel Disease (IBD) and asses the risk factor for developing NAFLD. Method We retrospectively investigated prevalence and predictors of NAFLD in patients with IBD. The diagnosis of NAFLD was based on the presence of ultrasonographic steatosis. Healthy controls with 1:1 ratio by gender, age, metabolic risk factors were matched randomly to compare of NAFLD detective rate and analyzing other risk factors. Results: A total of 120 patients, including 40 UC, 40 CD and 40 healthy controls (HC), were included in this study. There was no difference between the groups in terms of NAFLD frequency. Hyperlipidemia and DM were found to be risk factors for NAFLD in patients with IBD (p:0.004, p:0.03, respectively). Conclusion The frequency of NAFLD is not increased in IBD patients. Hyperlipidemia and DM are risk factors for NAFLD.

Anahtar Kelimeler

• Inflammatory Bowel Disease
• Ulcerative Colitis
• Crohn

Frequency and Risk Factors of Nonalcoholic Fatty Liver Disease Among Patients with Inflammatory Bowel Disease

Öz

Aim The aim of this study was to investigate the frequency of Nonalcoholic Fatty Liver Disease (NAFLD) in patients with Inflammatory Bowel Disease (IBD) and asses the risk factor for developing NAFLD. Method We retrospectively investigated prevalence and predictors of NAFLD in patients with IBD. The diagnosis of NAFLD was based on the presence of ultrasonographic steatosis. Healthy controls with 1:1 ratio by gender, age, metabolic risk factors were matched randomly to compare of NAFLD detective rate and analyzing other risk factors. Results: A total of 120 patients, including 40 UC, 40 CD and 40 healthy controls (HC), were included in this study. There was no difference between the groups in terms of NAFLD frequency. Hyperlipidemia and DM were found to be risk factors for NAFLD in patients with IBD (p:0.004, p:0.03, respectively). Conclusion The frequency of NAFLD is not increased in IBD patients. Hyperlipidemia and DM are risk factors for NAFLD.

Anahtar Kelimeler

• Fatty Liver
• Inflammatory Bowel Disease
• nonalcoholic fatty liver disease
• Ulcerative Colitis
• Crohn

Kaynakça

1. 1. Younossi Z, Anstee QM, Marietti M, Hardy T,Henry L, Eslam M, et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. 2018;15(1):11-20.
2. 2. Ahmed A, Wong RJ, Harrison SA. NonalcoholicFatty- LiverDiseaseReview: Diagnosis, Treatment, andOutcomes. Clin Gastroenterol Hepatol. 2015, 13, s. 2062.
3. 3. Nasr P, Ignatova S, Kechagias S, Ekstedt M. Natural history of nonalcoholic fatty liver disease: A prospective follow- up study with serial biopsies. Hepatol Commun 2018; 2:199.
4. 4. Machado MV, Diehl AM. Pathogenesis of Non-alcoholic Steatohepatitis. Gastroenterology 2016; 150:1769.
5. 5. Nguyen DL, Bechtold ML, Jamal MM. National trends and inpatient outcomes of inflammatory bowel disease patients with concomitant chronic liver disease. Scand J Gastroenterol. 2014;49:10915.
6. 6. Chao CY, Battat R, Al Khoury A. Co-existence of nonalcoholic fatty liver disease and inflammatory bowel disease: a review article. World J Gastroenterol 2016; 22: 727–7734.
7. 7. Nguyen DL, Bechtold ML, Jamal MM. National trends and inpatient outcomes of inflammatory bowel disease patients with concomitant chronic liver disease. Scand J Gastroenterol. 2014;49:10915.
8. 8. Sourianarayanane A, Garg G, Smith TH, et al. Risk factors of non-alcoholic fatty liver disease in patients with inflammatory bowel disease. J Crohn Colitis. 2013 ;7(8):e279-85.

9. 9. Satapathy SK, Garg S, Chauhan R, et al. Beneficial effects of tumor necrosis factor-alpha inhibition by pentoxifylline on clinical, biochemical, and metabolic parameters of patients with nonalcoholic steatohepatitis. Am J Gastroenterol. Oct; 2004;99:10.
10. 10. Florian R , Latella G, Magro F, et al. European Crohn’s and Colitis Organisation topical review on prediction, diagnosis and management of fibrostenosing Crohn’s disease. J Crohn's and Colitis, 2016, 10.8: 873-85.
11. 11. EASL-EASD-EASO Clinical Practice Guidelines for the Management of Non-Alcoholic Fatty Liver Disease 2016;9(2):65-90.
12. 12. Drossman D. Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features, and Rome IV. Gastroenterol 2016;150:1262–1279
13. 13. Principi, Mariabeatrice, Losurdo G., et al. Nonalcoholic fatty liver disease in inflammatory bowel disease: prevalence and risk factors. Inflamm Bowel Dis. 24.7 2018: 1589-1596.
14. 14. Williams, Christopher D., Asike M., et al. Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. Gastroenterol 2011;140(1): 124-131.
15. 15. Glassner K, Malaty HN, Abraham BP. Epidemiology and risk factors of nonalcoholic fatty liver disease among patients with inflammatory bowel disease. Inflamm Bowel Dis. 2017; 23: 998-1003.
16. 16. Yilmaz Y, Yilmaz N, Ateş F, et al. The prevalence of metabolic associated fatty liver disease in the Turkish population: A multicenter study. Hepatol Forum 2021;2:37-42.
17. 17. Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatol 2018;67(1):328-57.
18. 18. Younossi Z. Non-alcoholic fatty liver disease - A global public health perspective. J Hepatol 2019;70(3):531-544.
19. 19. Sourianarayanane A, Risk factors of Non-alcoholic fatty liver disease in patients with inflammatory bowel disease. J Crohn’s Colitis 2013; 8: 279–285.
20. 20. Sartini A, Gitto S, Bianchini M, Verga MC, et al. Non-alcoholic fatty liver disease in patients with inflammatory bowel disease. Cell Death Dis. 2018; 9: 87.
21. 21. Cappello M, Randazzo C, Bravatà I, et al. Liver function test abnormalities in patients with inflammatory bowel diseases: a hospital-based survey. Clin Med Insights Gastroenterol. 2014;7:25–31.
22. 22. Lin, A., Roth, H., Anyane-Yeboa, A., Rubin, D. T., & Paul, S. Prevalence of nonalcoholic fatty liver disease in patients with inflammatory bowel disease: a systematic review and meta-analysis. Inflammatory Bowel Diseases, 2021;27(6), 947-955.