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

Abstract

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.

Effects of inhaled beclomethasone dipropionate/formoterol fumarate/glycopyrronium on diaphragmatic workload and lung function in uncontrolled asthma: a case report

“…Thus far, no report has been published about the potential utility of diaphragmatic ultrasound in adult patients with uncontrolled asthma. However, considering the increasing application of ultrasounds in clinical practice, e.g., to evaluate right heart dysfunction ( 17 ), presence or absence of pleural effusion ( 18 ), COPD abnormalities ( 19 ), and liver diseases ( 20 ), we decided to study diaphragmatic function using ultrasound in a patient with uncontrolled asthma, before and after therapy with BDP/FF/G. Diaphragmatic ultrasound is not routinely used to follow-up adult patients with severe asthma, before and after inhaled treatments.…”

Association between alanine aminotransferase to high-density lipoprotein cholesterol ratio and nonalcoholic fatty liver disease: a retrospective cohort study in lean Chinese individuals

“…Although NAFLD has also frequently been seen in obese people 4 , the percentage of NAFLD in lean or non-obese patients is increasing 5 – 7 . Within the United States, the prevalence of NAFLD is estimated at 23% 8 , with up to 7–20% of lean individuals suffering from hepatic steatosis 9 , 10 . Hepatic steatosis has been found in 8–19% of lean people in Asian populations 11 .…”

Association between cataract and fatty liver diseases from a nationwide cross-sectional study in South Korea

“…These are factors that can also affect cataracts 11 , 12 , so it can be hypothesized that cataracts and fatty liver are closely related. The two diseases may be connected through various mechanisms; for example, patients with inflammatory bowel disease have a high prevalence of both fatty liver and cataract 13 , 14 .…”