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Inflammatory bowel disease associated with risk for developing NAFLD

LAS VEGAS — Patients with inflammatory bowel disease are more likely to develop nonalcoholic fatty liver disease, particularly those with ulcerative colitis, according to data presented at the 2012 of Gastroenterology Annual Scientific Meeting.

In a retrospective case-control study, researchers evaluated data from 56,568 hospitalized adult patients with primary or secondary IBD, along with matched non-IBD controls. The IBD cohort was selected from the Nationwide Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality. Incidence of nonalcoholic fatty liver disease (NAFLD) was present in both groups in order to analyze the impact of IBD on NAFLD prevalence.

NAFLD was observed in 2.6% of patients in the IBD group, which was at an elevated risk for the condition compared with controls after adjusting for confounders (OR=1.84; 95% CI, 1.66-2.01). White race (82.2% vs. 68.8%), male sex (42.3% vs. 39.7%), tobacco use (22.8% vs. 20.5%) and younger age (mean 52 years compared with 57 years) were all more common in the IBD group than controls. Patients with IBD also were less likely than controls to be obese (6.7% vs. 9.1%) or have been diagnosed with diabetes (14.7% vs. 22.9%) or hypertension (35% vs. 45.9%) (P<.0001 for all).

Among patients with IBD, the risk for NAFLD was further elevated among obese patients, particularly those with diabetes (OR=2.10; 95% CI, 1.46-3.02). Patients aged 44 years and younger also had an increased NAFLD risk compared with older IBD patients (OR=2.01; 95% CI, 1.64-2.47).

Ulcerative colitis comprised 36.2% of the IBD cases, with the remaining 63.8% diagnosed with Crohn’s disease. Investigators said the risk for NAFLD was greater among ulcerative colitis patients (OR=2.07; 95% CI, 1.85-2.33) than among those with Crohn’s disease (OR=1.69; 95% CI, 1.51-1.88), and indicated that further study was necessary to evaluate NAFLD prevalence related to ulcerative colitis.

“Patients with IBD have twofold higher risk for developing NAFLD compared with their non-IBD counterparts,” researcher Sumant Inamdar, MD, MPH, Hofstra North Shore-LIJ School of Medicine, told Healio.com. “This risk is higher among patients who have traditional risk factors for NAFLD, like diabetes and in patients who are obese. [However,] even though patients with IBD might not be obese or have other traditional risk factors for NAFLD, [clinicians] need to consider this among patients with abnormal liver function tests.”

For more information:

Inamdar S. P410: Increased Risk of Nonalcoholic Fatty Liver Disease Among Patients With Inflammatory Bowel Disease. Presented at: the 2012 American College of Gastroenterology Annual Scientific Meeting; Oct. 19-24, Las Vegas.