Abstract
BACKGROUND: Although is not yet established, recent studies suggest an increase prevalence of hepatic steatosis (HS) in patients with inflammatory bowel disease (IBD). Factors such as chronic inflammation, previous surgeries, drug-induced hepatotoxicity, malnutrition and intestinal dysbiosis seem to be involved in the pathogenesis of this disease. Aim: To assess the frequency of HS in IBD patients quantified by CAP (controlled attenuation parameter) and by clinical-analytical methods: Hepatic Steatosis Index (HSI) and Fatty Liver Index (FLI). A secondary aim is to investigate risk factors associated with HS in IBD patients. METHODS: Cross-sectional study that included consecutive outpatients that were observed in our department between January and March 2017. Patients with known liver disease or alcohol habits were excluded. HS was defined as HSI ≥ 36 or FLI ≥ 60 or CAP> 248. RESULTS: 149 patients included with mean age 40.7 ± 13 years, 83 female (55.7%), 59.7% with Crohn's disease (CD). 62 patients (41.7%) had CAP> 248, 20 (13.4%) FLI> 60 and 40 (26.8%) HSI> 36. There were no differences in the mean CAP value (244 ± 54.2), HSI (33.3 ± 5.18), and FLI (31.5 ± 25.3) among patients with CD and Ulcerative Colitis. We found that patients with CAP> 248 were more frequently obese (27.4% vs 0% p <0.001), males (54.8% vs. 36.8% P=0.029) and presented more frequently metabolic syndrome (25% vs 4.6% p <0.001). Regarding the IBD factors, patients with HS had a higher frequency of previous surgeries (30.6% vs16.1% P=0.035). There were no differences between hospitalization, duration of the disease, use of corticosteroids or other IBD treatments. CONCLUSION(S): In our cohort, the frequency of HS varied between 13.4% and 41.7% defined by non-invasive methods. We found that the presence of metabolic syndrome and obesity were more frequent in patients with HS. Regarding factors related to IBD, patients with previous history of surgery were more frequently diagnosed with HS.
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