Risk Factors and Impact of Metabolic Dysfunction -Associated Steatotic Liver Disease in Patients With Inflammatory Bowel Disease

Brief Summary

Detailed Description

Inflammatory bowel diseases (IBD) are chronic diseases characterized by remitting and relapsing inflammation of the gastrointestinal tract, with negative effects on the patients' social function and quality of life. Crohn's disease (CD) and ulcerative colitis (UC) are the two main types of IBD that present specific characteristics and their incidence and prevalence are globally increasing. In about 5-50% of patients with IBD, there are several extraintestinal manifestations such as musculoskeletal, ocular, cutaneous, and hepatobiliary. Hepatobiliary manifestations include primary sclerosing cholangitis, autoimmune/granulomatous hepatitis, and in particular, non-alcoholic fatty liver disease (NAFLD). NAFLD currently the most common chronic liver disease worldwide. Its global prevalence increased over 3 decades from 25.3% to 38%. NAFLD is a spectrum of hepatic diseases associated with metabolic and cardiovascular disorders, such as obesity, insulin resistance (IR), hypertension, dyslipidemia, impaired glucose tolerance and type 2 diabetes mellitus. It is frequently recognized as the hepatic manifestation of metabolic syndrome. Therefore, a new broader nomenclature has been introduced that is "Metabolic Dysfunction-associated Fatty Liver Disease" (MAFLD). More recently, a multi society Delphic consensus statement on a new nomenclature of fatty liver disease was published, introducing the term "Metabolic Dysfunction- associated Steatotic Liver Disease (MASLD) to make the term NAFLD retired. Estimates of liver steatosis prevalence in IBD patients vary widely from 8% to 88%. This could be explained by heterogeneity of the diagnostic methods and the selected study population. The risk factors of developing liver steatosis in patients with IBD remain undetermined. Some studies have supported traditional risk factors, such as type 2 Diabetes mellitus (T2DM), weight gain, or obesity, to contribute to MAFLD development in patients with IBD. Other studies have highlighted the involvement of disease activity, duration, drug-induced liver injury and small bowel surgeries in MAFLD progression. Several serum scores (biomarkers) have been developed to predict the presence or absence of hepatic steatosis. These scores have been extensively validated both for the general population and obese population. However, little is known about their usefulness in prediction of steatosis in IBD patients. IBD and fatty liver disease are both associated with considerable healthcare expenditures, and their increasing prevalence would undoubtedly impose a growing economic burden. Moreover, IBD patients with concurrent fatty liver disease are potentially at a higher risk of liver abnormalities compared with those without, which can affect the clinical management of the patients with IBD. Soni reported greater mortality, morbidity and health care resources utilization in patients with IBD who were hospitalized with concomitant diagnosis of NAFLD.

Primary Outcomes

Secondary Outcomes

• Performance of serum steatosis markers in prediction of steatosis(from 1st April 2024 to 30th June 2025)