Increased risk of MAFLD and Liver Fibrosis in Inflammatory Bowel Disease Independent of Classic Metabolic Risk Factors

• Published in: Clinical gastroenterology and hepatology Vol. 21; no. 2; pp. 406 - 414.e7
• Main Authors: Rodriguez-Duque, Juan Carlos, Calleja, José Luis, Iruzubieta, Paula, Hernández-Conde, Marta, Rivas-Rivas, Coral, Vera, María Isabel, Garcia, Maria Jose, Pascual, Marta, Castro, Beatriz, García-Blanco, Agustín, García-Nieto, Enrique, Olmo, Soraya Curiel-del, Cagigal, María Luisa, Lopez-Montejo, Lorena, Fernández-Lamas, Tatiana, Rasines, Laura, Fortea, José Ignacio, Vaque, José Pedro, Frias, Yza, Rivero, Montserrat, Arias-Loste, María Teresa, Crespo, Javier
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2023
• Subjects: Case-Control Studies; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Female; Humans; Inflammatory Bowel Disease; Inflammatory Bowel Diseases - complications; Liver Cirrhosis - complications; Liver Cirrhosis - epidemiology; Liver Fibrosis; MAFLD; Male; Metabolic Syndrome; Non-alcoholic Fatty Liver Disease; Risk Factors; NAFLD; TD2; ALT; IBD; Liver Fibrosis; HDL; GFR; HUMV; LDL; Metabolic Syndrome; Inflammatory Bowel Disease; IMID; BMI; CD; AST; OR; CI; HUPH; LSM; NASH; MAFLD; TE; CAP; GGT; APRI; FIB-4
• ISSN: 1542-3565; 1542-7714
• DOI: 10.1016/j.cgh.2022.01.039

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). We aimed to determine MAFLD prevalence and risk factors in IBD patients. 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. Eight hundred thirty-one 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 < .001). A diagnosis of IBD was an independent predictor of MAFLD (adjusted odds ratio, 1.99; P < .001) and an independent risk factor for advanced liver fibrosis (adjusted odds ratio, 5.55; P < .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. MAFLD and liver fibrosis are particularly prevalent in IBD patients, regardless of the influence of classic metabolic risk factors. [Display omitted]