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Metabolic Dysfunction-Associated Steatotic Liver Disease in Patients with Inflammatory Bowel Diseases: A Pilot Study
Ludovico Abenavoli1, Rocco Spagnuolo1, Giuseppe Guido Maria Scarlata1
1Department of Health Sciences, University "Magna Græcia", Viale Europa, 88100 Catanzaro, Italy.
Background:
Inflammatory bowel disease (IBD) is characterized by persistent inflammation and is often associated with metabolic dysfunction-associated steatotic liver disease (MASLD). IBD patients are at risk of developing MASLD due to shared risk factors such as gut dysbiosis and systemic inflammation. The new MASLD nomenclature emphasizes the link between liver steatosis and cardiometabolic comorbidities. However, the prevalence of MASLD in IBD patients remains poorly explored. The main aim of this cross-sectional study is to assess the prevalence of ultrasound (US) and the clinical features of MASLD in patients with IBDs.
Materials And Methods:
We conducted a retrospective study enrolling 272 Italian IBD patients attending Renato Dulbecco Teaching Hospital in a period between 1 January 2021 and 31 December 2023. MASLD was diagnosed based on the presence of liver steatosis with cardiometabolic risk factors, using established guidelines. Demographic, clinical, and laboratory data were collected and analyzed. Statistical significance was determined at a p-value < 0.05.
Results:
Of the 272 IBD patients, 6% had non-alcoholic fatty liver disease (NAFLD), while 18% had MASLD. Patients with IBD-MASLD were significantly older, had higher body mass index, waist circumference, and triglyceride levels, and were more likely to have type 2 diabetes mellitus and hypertension compared to those with IBD-NAFLD. IBD-MASLD patients also showed higher disease activity scores and required more frequent surgical interventions. Bivariate logistic regression revealed triglyceride levels as a significant predictor of MASLD in IBD patients.
Conclusions:
MASLD is more prevalent in IBD patients, highlighting the importance of early detection of liver steatosis in this at-risk population. The association between MASLD and cardiometabolic risk factors underscores the need for a multidisciplinary approach to manage these patients effectively. Further studies in larger cohorts are necessary to confirm these findings and explore the pathophysiological mechanisms involved.
Insights
Metabolic dysfunction-associated steatotic liver disease (MASLD) affects 18% of inflammatory bowel disease (IBD) patients, often linked to higher disease activity and cardiometabolic risks. Early detection and multidisciplinary management are crucial for this at-risk population.
Area of Science:
- Gastroenterology and Hepatology
- Metabolic Diseases
- Clinical Research
Background:
- Inflammatory bowel disease (IBD) is associated with metabolic dysfunction-associated steatotic liver disease (MASLD) due to shared risk factors like gut dysbiosis and inflammation.
- The updated MASLD nomenclature highlights liver steatosis's link to cardiometabolic conditions.
- The prevalence of MASLD in IBD patients is not well-established.
Purpose of the Study:
- To determine the prevalence of MASLD in Italian IBD patients using ultrasound.
- To investigate the clinical characteristics of MASLD in this cohort.
- To identify potential predictors of MASLD in IBD.
Main Methods:
- A retrospective study of 272 Italian IBD patients (January 2021 - December 2023).
- MASLD diagnosis based on liver steatosis and cardiometabolic risk factors per established guidelines.
- Collection and analysis of demographic, clinical, and laboratory data; statistical significance set at p < 0.05.
Main Results:
- MASLD was identified in 18% of IBD patients, compared to 6% with non-alcoholic fatty liver disease (NAFLD).
- IBD-MASLD patients were older, with higher BMI, waist circumference, triglycerides, and increased prevalence of type 2 diabetes and hypertension.
- IBD-MASLD was associated with higher disease activity and more surgical interventions; elevated triglycerides predicted MASLD.
Conclusions:
- MASLD is more prevalent in IBD patients than previously thought, emphasizing the need for liver steatosis screening.
- The link between MASLD and cardiometabolic factors in IBD necessitates a multidisciplinary management strategy.
- Further research in larger cohorts is required to validate findings and elucidate underlying mechanisms.
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