Nonalcoholic Fatty Liver Disease Increases Cardiovascular Risk in Inflammatory Bowel Diseases

Kablawi, Dana; Aljohani, Faisal; Palumbo, Chiara Saroli; Restellini, Sophie; Bitton, Alain; Wild, Gary; Afif, Waqqas; Lakatos, Péter L.; Bessissow, Talat; Sebastiani, Giada

doi:10.1093/crocol/otad004

Cited by 3 publications

(15 citation statements)

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“…Eighty-eight full-texts were reviewed, excluding 65 additional reports being the most frequent reasons: lack of liver fibrosis assessment in IBD population with NAFLD (n = 27), conference abstracts (n = 18), and studies focused on patients receiving hepatotoxic drugs (n = 13). Finally, 23 studies were included in the systematic review [ 10 , 11 , 12 , 16 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ].…”

Section: Resultsmentioning

confidence: 99%

“…All the included studies were observational, including 10 (43.5%) cross-sectional studies [ 11 , 12 , 32 , 34 , 36 , 38 , 39 , 40 , 46 , 48 ], 10 (43.5%) cohort studies [ 10 , 31 , 33 , 35 , 37 , 42 , 43 , 45 , 47 , 49 ], and 3 (13%) case-control studies [ 16 , 41 , 44 ] ( Table S1 ). All studies were published between 2015 and 2023.…”

Section: Resultsmentioning

confidence: 99%

“…All studies were published between 2015 and 2023. Eleven (47.8%) were conducted in North America [ 10 , 11 , 12 , 32 , 33 , 34 , 35 , 38 , 39 , 41 , 42 ], ten (43.5%) in Europe [ 16 , 36 , 37 , 40 , 43 , 44 , 45 , 46 , 47 , 48 ] and two (8.7%) in Asia [ 31 , 49 ]. Only six (26.1%) studies had a control group composed by patients without IBD [ 16 , 32 , 36 , 37 , 41 , 44 ].…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the diagnostic method for NAFLD, 3 performed a retrospective review of database records [ 10 , 35 , 42 ], 2 combined liver US and TE [ 48 , 49 ], 5 used US [ 31 , 36 , 39 , 40 , 44 ], 6 used TE [ 12 , 16 , 38 , 45 , 46 , 47 ], 2 used laboratory tests alone [ 33 , 37 ], 3 liver histology [ 32 , 34 , 43 ], 1 computed tomography [ 11 ], and 1 Magnetic Resonance [ 41 ]. Regarding the diagnostic method for liver fibrosis, two performed a retrospective review of database records [ 10 , 35 ], 10 used TE [ 12 , 16 , 36 , 38 , 40 , 45 , 46 , 47 , 48 , 49 ], seven used laboratory tests alone [ 11 , 31 , 33 , 37 , 39 , 41 , 42 ], two used liver histology [ 32 , 34 ], one used a combination of TE and laboratory tests [ 44 ], and one used a combination of TE and histology [ 43 ]. Therefore, NAFLD and liver fibrosis were assessed by non-invasive methods in 20 (86.9%) and 21 (91.3%) studies, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, NAFLD and liver fibrosis were assessed by non-invasive methods in 20 (86.9%) and 21 (91.3%) studies, respectively. Studies using TE for liver fibrosis assessment defined significant liver fibrosis as liver stiffness above 7 kPa in five (41.7%) studies [ 12 , 40 , 43 , 45 , 48 ], 7.2 kPa [ 16 , 46 ] in two (16.7%) studies, 7.3 kPa [ 47 ] in one (8.3%) study, 7.7 kPa in one (8.3%) study [ 36 ], ≥8 kPa [ 38 , 49 ] in two (16.7%) studies, and no specified in one (8.3%) study [ 44 ].…”

Section: Resultsmentioning

confidence: 99%

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Liver Fibrosis in Non-Alcoholic Fatty Liver Disease and Progression to Hepatocellular Carcinoma in Patients with Inflammatory Bowel Disease: A Systematic Review

Martínez

García-Mateo

Laredo

et al. 2023

Cancers

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The aim of the systematic review is to assess the prevalence and risk factors of liver fibrosis in patients with Inflammatory Bowel Disease (IBD) and Non-Alcoholic Fatty Liver Disease (NAFLD) and to discuss the role of liver fibrosis in the progression to hepatocellular carcinoma (HCC). We performed a structured search in PubMed, Web of Science, Embase, and Scopus up to 3 March 2023 to identify observational studies reporting liver fibrosis in patients with NAFLD and IBD. Quality of studies was assessed using the Newcastle-Ottawa Scale (NOS) score. A total of 23 studies met our inclusion criteria, including 629,781 patients. A total of 10 cross-sectional, 3 case-control, and 10 cohort studies were included. Fourteen studies had a NOS score ≥ 7 points. NAFLD was diagnosed in 2162/6332 (34.1%) IBD participants. However, NAFLD diagnosis was established in 924/2962 (31.2%) healthy individuals without IBD. Advanced liver fibrosis was found in 116 (11.6%) of 992 IBD patients with NAFLD. Most studies found an association between NAFLD and classic cardiovascular risk factors such as older age, male sex, higher BMI, diabetes, hypertension and dyslipidemia. In addition, metabolic syndrome features were also associated with an increased risk of significant and advanced liver fibrosis. Although no strong association between NAFLD and IBD therapy was reported, some studies associated NAFLD with IBD diagnosis, Crohn’s Disease, a complicated course of IBD, disease activity, and IBD duration. Advanced liver fibrosis was also associated with Crohn’s disease in several studies. In conclusion, NAFLD and advanced liver fibrosis are prevalent and clinically relevant extraintestinal manifestations, so its diagnosis and potential progression to HCC should be carefully considered in daily clinical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Liver Fibrosis in Non-Alcoholic Fatty Liver Disease and Progression to Hepatocellular Carcinoma in Patients with Inflammatory Bowel Disease: A Systematic Review

Martínez

García-Mateo

Laredo

et al. 2023

Cancers

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Heavy arch: from inflammatory bowel diseases to metabolic disorders

Adolph,

Meyer,

Jukic

et al. 2024

Gut

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BackgroundMetabolic disorders and inflammatory bowel diseases (IBD) have captured the globe during Westernisation of lifestyle and related dietary habits over the last decades. Both disease entities are characterised by complex and heterogeneous clinical spectra linked to distinct symptoms and organ systems which, on a first glimpse, do not have many commonalities in clinical practice. However, experimental studies indicate a common backbone of inflammatory mechanisms in metabolic diseases and gut inflammation, and emerging clinical evidence suggests an intricate interplay between metabolic disorders and IBD.ObjectiveWe depict parallels of IBD and metabolic diseases, easily overlooked in clinical routine.DesignWe provide an overview of the recent literature and discuss implications of metabolic morbidity in patients with IBD for researchers, clinicians and healthcare providers.ConclusionThe Western lifestyle and diet and related gut microbial perturbation serve as a fuel for metabolic inflammation in and beyond the gut. Metabolic disorders and the metabolic syndrome increasingly affect patients with IBD, with an expected negative impact for both disease entities and risk for complications. This concept implies that tackling the obesity pandemic exerts beneficial effects beyond metabolic health.

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Ultrasound Prevalence and Clinical Features of Nonalcoholic Fatty Liver Disease in Patients with Inflammatory Bowel Diseases: A Real-Life Cross-Sectional Study

Abenavoli,

Spagnuolo,

Scarlata

et al. 2023

Medicina

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Background and Objectives: Inflammatory bowel disease (IBD) is a condition characterized by chronic intestinal inflammation. We can identify two major forms: Crohn’s disease (CD) and ulcerative colitis (UC). One of the extraintestinal manifestations of IBD is nonalcoholic fatty liver disease (NAFLD). IBD and NAFLD share common pathogenetic mechanisms. Ultrasound (US) examination is the most commonly used imaging method for the diagnosis of NAFLD. This cross-sectional observational retrospective study aimed to evaluate the US prevalence of NAFLD in IBD patients and their clinical features. Materials and Methods: A total of 143 patients with IBD underwent hepatic US and were divided into two different groups according to the presence or absence of NAFLD. Subsequently, new exclusion criteria for dysmetabolic comorbidities (defined as plus) were applied. Results: The US prevalence of NAFLD was 23% (21% in CD and 24% in UC, respectively). Most IBD–NAFLD patients were male and older and showed significantly higher values for body mass index, waist circumference, disease duration, and age at onset than those without NAFLD. IBD–NAFLD patients showed a significantly higher percentage of stenosing phenotype and left-side colitis. Regarding metabolic features, IBD–NAFLD patients showed a significantly higher percentage of hypertension and IBD plus dysmetabolic criteria. Also, higher values of alanine aminotransferase and triglycerides and lower levels of high-density lipoproteins are reported in these patients. Conclusions: We suggest performing liver US screening in subjects affected by IBD to detect NAFLD earlier. Also, patients with NAFLD present several metabolic comorbidities that would fall within the new definition of metabolic-associated fatty liver disease. Finally, we encourage larger longitudinal studies, including healthy controls, to provide further confirmation of our preliminary data.

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Nonalcoholic Fatty Liver Disease Increases Cardiovascular Risk in Inflammatory Bowel Diseases

Cited by 3 publications

References 39 publications

Liver Fibrosis in Non-Alcoholic Fatty Liver Disease and Progression to Hepatocellular Carcinoma in Patients with Inflammatory Bowel Disease: A Systematic Review

Liver Fibrosis in Non-Alcoholic Fatty Liver Disease and Progression to Hepatocellular Carcinoma in Patients with Inflammatory Bowel Disease: A Systematic Review

Heavy arch: from inflammatory bowel diseases to metabolic disorders

Ultrasound Prevalence and Clinical Features of Nonalcoholic Fatty Liver Disease in Patients with Inflammatory Bowel Diseases: A Real-Life Cross-Sectional Study

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