Systematic Review and Meta-Analysis: Prevalence of Non-Alcoholic Fatty Liver Disease and Liver Fibrosis in Patients with Inflammatory Bowel Disease

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is a common concomitant condition in patients with inflammatory bowel disease (IBD). We aim to assess the magnitude of this association. Methods: We searched MEDLINE, EMBASE and Scopus libraries for the period up to February 2023 to identify studies reporting cohorts of IBD patients in which NALFLD was evaluated. Results: Eighty-nine studies were analyzed. The overall prevalence of NAFLD was 24.4% (95%CI, 19.3–29.8) in IBD, 20.2% (18.3–22.3) in Crohn’s disease and 18.5% (16.4–20.8) for ulcerative colitis. Higher prevalence was found in male compared to female patients, in full papers compared to abstracts, and in cross-sectional studies compared to prospective and retrospective ones. The prevalence of NAFLD in IBD has increased in studies published from 2015 onwards: 23.2% (21.5–24.9) vs. 17.8% (13.2–22.9). Diagnostic methods for NAFLD determined prevalence figures, being highest in patients assessed by controlled attenuation parameter (38.8%; 33.1–44.7) compared to ultrasonography (28.5%; 23.1–34.2) or other methods. The overall prevalence of fibrosis was 16.7% (12.2–21.7) but varied greatly according to the measurement method. Conclusion: One-quarter of patients with IBD might present with NAFLD worldwide. This proportion was higher in recent studies and in those that used current diagnostic methods.

Inflammatory Bowel Diseases and Non-Alcoholic Fatty Liver Disease: Piecing a Complex Puzzle Together

“…The prevalence of liver fibrosis in the IBD population varies in different studies, reaching up to 16.7% [ 24 ], and there is some evidence revealing higher percentages among NAFLD patients with IBD compared to those without IBD [ 25 , 26 ]. In the aforementioned retrospective American study by Ritaccio et al, liver fibrosis was assessed non-invasively through the NALFD fibrosis score (NFS), which includes age, body mass index, diabetes, platelet count, transaminase levels and serum albumin.…”

Gut Microbiota Profile Changes in Patients with Inflammatory Bowel Disease and Non-Alcoholic Fatty Liver Disease: A Metagenomic Study

“…The prevalence of NAFLD in the general population has increased significantly over time, from 25.5% before 2005 to 37.8% in 2016 or later [11]. A recent epidemiologic study investigating the occurrence of hepatobiliary conditions in IBD patients revealed a median 26% prevalence of NAFLD [12,13]. Crucially, patients with IBD exhibit an elevated rate of NAFLD diagnosis independent of traditional metabolic risk factors, such as obesity and diabetes [14].…”