NonAlcoholic Fatty Liver Disease in Patients with Inflammatory

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Non-Alcoholic Fatty Liver Disease in Patients with Inflammatory Bowel Disease - A Asian Cohort

Non-Alcoholic Fatty Liver Disease in Patients with Inflammatory Bowel Disease - A Asian Cohort Study Lisha Wu 1, Yu-Chun Hsu 1, Hsu-Heng Yen 1, Yang-Yuan Chen 1 1 Changhua Christian Hospital. Background Increased prevalence of nonalcoholic fatty liver disease (NAFLD) is observed in patients with inflammatory bowel disease (IBD) from the Western country. Both intestinal inflammation and metabolic factors are to contribute to the pathogenesis of IBD-associated NAFLD. The burden of NAFLD is not clear in the Asian population. Aim To evaluate the prevalence of NAFLD and liver fibrosis in a cohort of Asian IBD patients. Methods From 2019. 01 to 2019. 12, IBD patients who received ultrasound examination was enrolled. Hepatic steatosis and fibrosis was measured with liver stiffness measurement (LSM ) and controlled attenuation parameter (CAP) using Fibro. Scan. Patients with a history of excessive alcohol or recent steroid use were excluded. Univariate and multivariate analysis were performed. Results A total of 90 consecutive patients were enrolled and included in the analysis (49 Ulcerative colitis, 41 Crohn's disease). The median age was 42 -year-old. The patients had normal weight (53. 3%), underweight (13. 3%), overweight (26. 7%) and obese (6. 7%). The CAP detected steatosis was S 0 (58. 9%), S 1(13. 3%), S 2(15. 6%) and S 3(12. 2%). Significant fibrosis was observed in 4. 4% of the patients. The UC patients have similar presentation of age, sex and CAP distribution. Table 2. Comparison of patients with and without NASH by Fibroscan Table 1. Demographic data of the patients Clinical variable Crohn’s Disease Ulcerative Colitis P Sex (M/F) 29/12 31/18 0. 4568 Age (mean, SD) 40. 17(16. 56) 43. 82(12. 91 Variable NASH (+) NASH (-) P value Sex (M/F) 20/7 40/23 0. 3318 Age (mean, SD) 45. 22 (12. 61) 40. 84 (15. 44) 0. 1972 Disease duration (median, IQR) 4 (2 -5) 5 (3 -9. 75) 0. 0337 Prior Bowel Resection (Y/N) 8/19 11/52 0. 1973 0. 2440 Disease duration (median, IQR) 4 (3 -7) 5 (2 -8. 5) 0. 8773 Prior Bowel Resection (Y/N) 18/23 1/48 <0. 0001 CD/UC 13/14 28/35 0. 7478 Biologic (Y/N) 29/12 8/41 <0. 0001 Biologic (Y/N) 10/17 27/36 0. 6091 Weight (median, IQR) 63(54 -71. 25) 62. 5 (53 -74. 13) 0. 5596 Weight (median, IQR) 73 (70 -82) 58 (52 -65) <0. 0001 Height (median, IQR) 167 (158. 75 -174. 25) 166 (161. 75 -171. 25) 0. 8553 Height (median, IQR) 171 (163. 5 -174. 75) 165 (160 -170) 0. 0414 BMI (median, IQR) 22. 15(19. 41 -25. 34) 22. 58(20. 65 -25. 99) 0. 2258 BMI (median, IQR) 25. 88 (24. 86 -28. 23) 21. 50 (19. 35 -23. 70) <0. 0001 Weight Class (Underweight/Normal weight/Overweight/Obese) 0/7/16/4 12/41/8/2 <0. 0001 Significant Fibrosis F 2, 3, 4 (Y/N) 5/22 2/61 0. 0133 DM (Y/N) 3/24 1/62 0. 0457 Weight Class (Underweight/Normal 7/22/10/2 5/26/14/4 0. 7293 weight/Overweight/Obese) DM (Y/N) 3/38 1/48 0. 2290 Hyperlipidemia (Y/N) 1/40 0/49 0. 2743 Hyperlipidemia (Y/N) 1/26 0/63 0. 1266 Hypertension (Y/N) 3/38 1/48 0. 2290 Hypertension (Y/N) 3/24 1/62 0. 0457 GB Stone (Y/N) 8/33 2/47 0. 0211 GB Stone (Y/N) 4/23 6/57 0. 4667 Hepatitis B (Y/N) 3/24 6/57 0. 8191 Hepatitis C (Y/N) 0/27 3/60 0. 2514 WBC (median, IQR) 5. 8 (4. 9 -8. 38) 6 (5 -7. 18) 0. 9438 Hb (median, IQR) 14 (13. 4 -14. 88) 13. 4 (11. 78 -14. 5) 0. 0290 Plt(median, IQR) 256 (210. 5 -285) 266 (220 -327. 75) 0. 4384 GOT(median, IQR) 26 (18 -31) 23 (19 -25) 0. 0745 GPT(median, IQR) 23 (15. 25 -32. 75) 15 (12 -24. 5) 0. 0116 CRP(median, IQR) 0. 13 (0. 07 -0. 55) 0. 11 (0. 04 -0. 7) 0. 6022 ESR(median, IQR) 11 (4. 25 -16) 9 (5 -19) 0. 8178 Hepatitis B (Y/N) Hepatitis C (Y/N) CD Phenotype (B 1/B 2/B) 4/37 1/40 5/44 2/47 0. 9441 0. 6672 16/9/16 UC Phenotype (E 1/E 2/E 3) 6/24/16 WBC (median, IQR) 5. 7 (4. 9 -7. 33) 6 (4. 98 -7. 28) 0. 7829 Hb (median, IQR) 13. 4 (11. 93 -14. 4) 14. 1 (12. 7 -14. 73) 0. 0829 Plt(median, IQR) 256 (206 -328. 5) 268 (229. 75 -302. 75) 0. 4834 GOT(median, IQR) 24 (18 -27) 22 (18. 75 -26. 25) 0. 7164 GPT(median, IQR) 17 (12 -27) 16 (13 -31. 25) 0. 4631 CRP(median, IQR) 0. 13 (0. 05 -0. 97) 0. 11(0. 04 -0. 36) 0. 2908 ESR(median, IQR) 11. 5(6. 5 -28. 5) 9 (5 -13. 5) 0. 0706 Fibro. Scan CAP Value (median, IQR) 207 (169 -270) 208 (186. 25 -256. 75) 0. 6154 Fibro. Scan Elastic (median, IQR) 5. 1 (4. 08 -5. 65) 5. 1 (4. 18 -5. 8) 0. 8808 Conclusion In this study, the prevalence of NAFLD is low (30%) and patients with higher BMI are associated with NAFLD in our study. 中華民國109年消化系聯合學術演講年會 2020. 07. 11