Prevalence of fatty liver disease in patients with inflammatory bowel disease: a transient elastography study on the basis of a controlled attenuation parameter

Objective: Inflammatory bowel disease (IBD) is a chronic recurrent inflammatory disorder of the gastrointestinal tract which has an unknown etiology. In this study, we aimed to investigate the fatty liver disease frequency in IBD patients using transient elastography (TE) which is a non-invasive and accurate method for the diagnosis of liver fibrosis. Material and Methods: The data were collected from registered patients retrospectively. On the basis of previous studies, a cut-off value of 238 dB/m for controlled attenuation parameter (CAP) was used for the diagnosis of hepatic steatosis. In this study we have also settled CAP value above 238 dB/m as fatty liver. Results: A total of 99 patients were enrolled in the study. Mean age was 45.59 ± 11.72 years and 41 (41.4%) patients were female. Fifty-eight patients (58.6%) had Crohn’s disease, 39 (39.4%) had ulcerative colitis and 2 (2.0%) had indeterminate colitis. In 8 (8.1%) patients extra-large probe and in 91 (91.9%) patients medium probe was used to detect liver steatosis. Fatty liver disease was detected in 44 (44.4%) patients with IBD. Conclusion: Despite the nutrition disorders in IBD, fatty liver disease was seen in 44.4% of patients in our cohort. However, fatty liver disease may be seen without any aminotransferase elevation in IBD patients. Therefore, liver steatosis should always be kept in mind and careful attention should be paid during follow-up of patients with IBD in our daily practice.

___

  • 1. Rinella M E. Nonalcoholic fatty liver disease: a systematic review. JAMA 2015;313:2263-73. doi:10.1001/ jama.2015.5370
  • 2. EASL;EASD;EASO. Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol 2015;64:1388-402. doi:10.1016/j.jhep.2015.11.004
  • 3. Rockey D C, Caldwell S H, Goodman Z D, et al. Liver biopsy. Hepatology 2009; 49: 1017-44. doi:10.1002/hep.22742
  • 4. Schwenzer N F, Springer F, Schraml C, Stefan N, Machann J, Schick F. Non-invasive assessment and quantification of liver 70 Kani et al. Hepatic steatosis in inflammatory bowel disease Marmara Medical Journal 2019; 32: 68-70 steatosis by ultrasound, computed tomography and magnetic resonance. J Hepatol 2009;51:433-45. doi:10.1016/j. jhep.2009.05.023
  • 5. Sasso M, Beaugrand M, de Ledinghen V, et al. Controlled attenuation parameter (CAP): a novel VCTE guided ultrasonic attenuation measurement for the evaluation of hepatic steatosis: preliminary study and validation in a cohort of patients with chronic liver disease from various causes. Ultrasound Med Biol 2010; 36: 1825-35. doi:10.1016/j. ultrasmedbio.2010.07.005
  • 6. Sasso M, Miette V, Sandrin L, et al. The controlled attenuation parameter (CAP): a novel tool for the non-invasive evaluation of steatosis using Fibroscan. Clin Res Hepatol Gastroenterol 2012;36: 13-20. doi:10.1016/j.clinre.2011.08.001
  • 7. Sasso M, Tengher-Barna I, Ziol M, et al. Novel controlled attenuation parameter for noninvasive assessment of steatosis using Fibroscan((R)): validation in chronic hepatitis C. J Viral Hepat 2012;19:244-53. doi:10.1111/j.1365- 2893.2011.01534.x
  • 8. de Ledinghen, V, Vergniol J, Foucher J, et al. Non-invasive diagnosis of liver steatosis using controlled attenuation parameter (CAP) and transient elastography. Liver Int 2012; 32:911-8. doi:10.1111/j.1478-3231.2012.02820.x
  • 9. Boursier J, Cales P. Controlled attenuation parameter (CAP): a new device for fast evaluation of liver fat? Liver Int 2012;32:875-7. doi:10.1111/j.1478-3231.2012.02824.x
  • 10. Yılmaz Y, Ergelen R, Akin H, et al. Noninvasive detection of hepatic steatosis in patients without ultrasonographic evidence of fatty liver using the controlled attenuation parameter evaluated with transient elastography. Eur J Gastroenterol Hepatol 2013; 25:1330-34. doi:10.1097/ MEG.0b013e3283623a16
  • 11. Yilmaz Y, Yesil A, Gerin F, et al. Detection of hepatic steatosis using the controlled attenuation parameter: a comparative study with liver biopsy. Scand J Gastroenterol 2014; 49: 611- 6. doi:10.3109/00365.521.2014.881548
  • 12. Roman A L, Munoz F. Comorbidity in inflammatory bowel disease. World J Gastroenterol 2011;17: 2723-33. doi:10.3748/wjg.v17.i22.2723 13. Gisbert J P, Luna M, Gonzalez-Lama Y, et al. Liver injury in inflammatory bowel disease: long-term follow-up study of 786 patients. Inflamm Bowel Dis 2016;13:1106-14. doi:10.1002/ibd.20160
  • 14. Sourianarayanane A, Garg G, Smith T H, et al. Risk factors of non-alcoholic fatty liver disease in patients with inflammatory bowel disease. J Crohns Colitis 2013; 7: e279- 85. doi:10.1016/j.crohns.2012.10.015
  • 15. Bargiggia S, Maconi G, Elli M, et al. Sonographic prevalence of liver steatosis and biliary tract stones in patients with inflammatory bowel disease: study of 511 subjects at a single center. J Clin Gastroenterol 2003;36: 417-20. doi: 10.1097/00004.836.200305000-00012
  • 16. Barbero-Villares A, Mendoza Jimenez-Ridruejo J, Taxonera C, et al. Evaluation of liver fibrosis by transient elastography (Fibroscan(R)) in patients with inflammatory bowel disease treated with methotrexate: a multicentric trial. Scand J Gastroenterol 2012;47:575-9. doi:10.3109/00365.521.2011. 647412
  • 17. Thin L W, Lawrance I C, Spilsbury K, et al. Detection of liver injury in IBD using transient elastography. J Crohns Colitis 2014; 8: 671-7. doi:10.1016/j.crohns.2013.12.006
  • 18. Chao C Y, Battat R, Al Khoury A, et al. Co-existence of nonalcoholic fatty liver disease and inflammatory bowel disease: A review article. World J Gastroenterol 2016;22:7727-34. doi:10.3748/wjg.v22.i34.7727
  • 19. Myers R P, Pollett A, Kirsch R, et al. Controlled Attenuation Parameter (CAP): a noninvasive method for the detection of hepatic steatosis based on transient elastography. Liver Int 2012;32:902-10. doi:10.1111/j.1478-3231.2012.02781.x
  • 20. de Fazio C, Torgano G, de Franchis R, et al. Detection of liver involvement in inflammatory bowel disease by abdominal ultrasound scan. Int J Clin Lab Res 1992;21:314- 7. doi:10.1007/bf02591669
  • 21. Riegler G, D’Inca R, Sturniolo G C, et al. Hepatobiliary alterations in patients with inflammatory bowel disease: a multicenter study. Caprilli & Gruppo Italiano Studio Colon-Retto. Scand J Gastroenterol 198;33:93-8. doi:10.1080/003.655.29850166275
  • 22. Yamamoto-Furusho J K, Sanchez-Osorio M, Uribe M. Prevalence and factors associated with the presence of abnormal function liver tests in patients with ulcerative colitis. Ann Hepatol 2010;9:397-401.
  • 23. Bessissow T, Le N H, Rollet K, et al. Incidence and predictors of nonalcoholic fatty liver disease by serum biomarkers in patients with inflammatory bowel disease. Inflamm Bowel Dis 2016;22:1937-44. doi:10.1097/mib.000.000.0000000832
  • 24. Kaya E, Demir D, Alahdab Y O, et al. Prevalence of hepatic steatosis in apparently healthy medical students: a transient elastography study on the basis of a controlled attenuation parameter. Eur J Gastroenterol Hepatol
Marmara Medical Journal-Cover
  • ISSN: 1019-1941
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 1988
  • Yayıncı: Marmara Üniversitesi