Nonalcoholic Fatty Liver Disease Increases Cardiovascular Risk in Inflammatory Bowel Diseases

Area of Science:

• Hepatology
• Cardiology
• Gastroenterology

Background:

• Nonalcoholic fatty liver disease (NAFLD) is linked to cardiovascular disease (CVD) in the general population.
• Inflammatory bowel disease (IBD) patients exhibit higher prevalence of both NAFLD and CVD.
• This study investigates the impact of NAFLD and liver fibrosis on cardiovascular risk within the IBD population.

Purpose of the Study:

• To evaluate the association between NAFLD, liver fibrosis, and intermediate-to-high cardiovascular risk in patients with IBD.
• To identify predictors of elevated cardiovascular risk in IBD patients.

Main Methods:

• Prospective study of 405 IBD patients undergoing routine NAFLD screening using transient elastography (TE) and controlled attenuation parameter (CAP).
• NAFLD defined as CAP ≥275 dB m⁻¹, significant liver fibrosis as TE ≥8 kPa.
• Cardiovascular risk assessed using the ASCVD risk estimator; multivariable logistic regression identified predictors.

Main Results:

• Of 405 IBD patients, 31.9% had NAFLD and 8.6% had significant liver fibrosis.
• Intermediate-high cardiovascular risk was observed in 25.2% of patients.
• Independent predictors of intermediate-high ASCVD risk included NAFLD (aOR 2.97), longer IBD duration (aOR 1.55 per 10 years), and ulcerative colitis (aOR 2.32).

Conclusions:

• NAFLD is a significant predictor of intermediate-high cardiovascular risk in IBD patients.
• Targeted cardiovascular risk assessment is recommended for IBD patients with NAFLD.
• Particular attention should be given to IBD patients with longer disease duration and ulcerative colitis.