1190 Does Nonalcoholic Fatty Liver Disease Increase the Risk for Acute Ischemic Bowel Disease?

Abstract

INTRODUCTION: Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the United States. It has been reported in the literature that NAFLD increases the risk for cardiovascular disease, but a possible association between NAFLD and acute ischemic bowel disease (AIBD) has not been studied. Our aim in this study is to evaluate if NAFLD is an independent risk factor for AIBD. METHODS: Using data from the National Inpatient Sample (NIS) database between 2002 and 2014, we identified patients who were diagnosed with NAFLD and AIBD using appropriate ICD 9 coding. The control group was the patients who did not have a diagnosis of NAFLD. We then performed multivariate logistic regression analysis for the association between NAFLD and AIBD RESULTS: The total population was comprised of 101,137,143 patients, of which 365,701 (0.36%) were diagnosed with NAFLD and 133,201 (0.13%) were diagnosed with AIBD. Patients in the NAFLD group were older (53 vs 48), less likely to be females (57.7% vs 58.4%) and African American (9.3% vs 14.3%) (P < 0.0001 for all). In addition, NAFLD patients had more tobacco use (13.9% vs 9.5%), alcohol (7.1% vs 3.4%), obesity (26.2% vs 6.9%) and diabetes mellitus (DM) with or without complications (5.6% vs 3.2%) and (30.7% vs 14.1%) respectively. Furthermore, individuals in the NAFLD group had less comorbid chronic obstructive pulmonary disease (COPD) (9.5% vs 10.9%), congestive heart failure (CHF) (5.5% vs 6.5%), cardiovascular atherosclerosis (13.8% vs 17%) and atrial fibrillation (AFib) (5.8% vs 8.8%) (P < 0.0001 for all). Both groups had similar prevalence of major cardiovascular surgery (0.1%) (P > 0.05). Using Multivariate logistic regression, and after adjusting for potential cofounding factors including: (age, gender, race, obesity, COPD, CHF, DM, tobacco use, cardiovascular atherosclerosis, AFib and a history of major cardiovascular surgery), NAFLD group had a statistically significant higher rate of AIBD (Odds Ratio [OR], 2.11, 95% confidence interval [CI], 2.02-2.20, P < 0.0001) compared with the non-NAFLD group. CONCLUSION: Based on our analysis, patients in the NAFLD group were twice more likely to have AIBD. To our knowledge, this the first study that evaluated the risk for AIBD in NAFLD patients. This finding adds to our understanding of NAFLD as multisystem disease and highlights the importance of controlling the risk factors associated with NAFLD.