S1207 Association of Eosinophilic Esophagitis (EoE) with Non-alcoholic Fatty Liver Disease (NAFLD)

Abstract

Introduction: There is a strong association between eosinophilic esophagitis (EoE) and other allergic conditions, as well as associations with other inflammatory gastrointestinal disorders, such as celiac disease and inflammatory bowel disease (IBD). Interestingly, celiac disease and IBD are linked to inflammatory liver conditions, including autoimmune hepatitis (AIH), non-alcoholic fatty liver disease (NAFLD), and non-alcoholic steatohepatitis (NASH). This study retrospectively analyzed subjects with EoE to determine associations between EoE and NAFLD, as well as common risk factors for NAFLD including obesity, hyperlipidemia, and hyperglycemia. Methods: A retrospective chart review was performed for 350 subjects 19 years and older with a prior diagnosis of EoE and 350 patients in a gender and age-matched control group. Data abstracted included demographics (age, gender), body mass index (BMI), abdominal imaging results, and pertinent laboratory results associated with NAFLD, namely hemoglobin A1c, total cholesterol, LDL, aspartate aminotransferase (AST), alanine aminotransferase (ALT), INR, and platelet count. Descriptive statistics were used to summarize demographic and clinical characteristics. The Chi-square test or Fisher’s exact test was used to assess for associations between groups (EoE vs. control) and categorical subject data. The independent sample t-test was used to compare continuous measurements between groups. P < 0.05 was considered statistically significant. Results: There was not a statistically significant difference for gender between EoE and control groups (p = 0.29). There was a statistically significant difference in mean age between EoE subjects and controls (42 vs. 44 years, p = 0.03), however this was not deemed clinically significant. There were no differences between the two groups for BMI (p = 0.59), ALT (p = 0.20), LDL (p = 0.27), total cholesterol (p = 0.21), or platelet count (0.34). More subjects in the EoE group (26%) had radiographic evidence of fatty liver or cirrhosis compared to individuals without EoE (21%) and this trended towards significance (p=0.15). Conclusion: There was not a significant association between EoE and NAFLD or NAFLD risk factors. However, there was a trend towards increased incidence of fatty liver or cirrhosis detected on imaging in the EoE group as compared to the control group. Further studies are needed in larger populations to investigate this trend.