Gabrielle Ritaccio, MD1, Ameer Abutaleb, MD1, Lauren A. George, MD1, Samuel Salas, MS1, Raymond K. Cross, MD, MS2, Sasan Sakiani, MD1, Kirti Shetty, MD1, Uni Wong, MD1
1University of Maryland School of Medicine, Baltimore, MD; 2University of Maryland Medical Center, Baltimore, MD
Introduction: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disorder in western countries and an increasing cause of end stage liver disease and hepatocellular carcinoma (HCC). While patients with inflammatory bowel disease (IBD) are traditionally viewed as underweight and malnourished, increasingly effective therapies have led to similar rates of obesity in these patients when compared to the average population. The aims of this study were to 1) characterize rates of NAFLD in a large cohort of patients with IBD and 2) identify IBD-related predictors of NAFLD.
Methods: We conducted a single-center retrospective chart review of patients referred to our IBD program from 2007-2017. NAFLD was defined as imaging or biopsy findings of hepatic steatosis without coexisting liver disease or significant alcohol use. Relevant patient demographic and clinical data was collected within one year of NAFLD diagnosis. Comparisons between NAFLD rates in various groups were made using chi squared tests and one-way ANOVA tests.
Results: 1673 unique patients presented to our IBD program between the years 2007-2017. While patients were receiving care at our program, 237 (14%) had imaging or biopsy findings of hepatic steatosis. Of those 237 patients, 28 were excluded from analysis due to concurrent diagnosis of hepatitis C (n=7) or B virus infection (n=1), HIV infection (n=2), significant alcohol use (n=10), methotrexate-related liver injury (n=2), sarcoidosis of the liver (n=1), or primary sclerosing cholangitis (n=5). As expected, increasing BMI was associated with higher NAFLD rates (p=0.05). NAFLD rates were also significantly different between different types of IBD (p=0.02). 63% of NAFLD patients had Crohn’s disease (n=132/209) and 19% had ulcerative colitis (n=39/209). In patients with Crohn’s, disease location in the proximal colon and rectum was positively associated with NAFLD (p=0.02 and 0.02 respectively). NAFLD rates were not significantly different between types of Crohn’s disease phenotypes including inflammatory, obstructing, and perforating (p=0.77).
Discussion: NAFLD rates among patients with Crohn’s disease are high. Disease location in the proximal colon and rectum was associated with NAFLD while disease behavior was not. Further research is needed to determine mechanisms driving development NAFLD in patients with Crohn’s disease.
Citation: Gabrielle Ritaccio, MD; Ameer Abutaleb, MD; Lauren A. George, MD; Samuel Salas, MS; Raymond K. Cross, MD, MS; Sasan Sakiani, MD; Kirti Shetty, MD; Uni Wong, MD. P1405 - DISEASE LOCATION IS ASSOCIATED WITH NON-ALCOHOLIC FATTY LIVER DISEASE IN PATIENTS WITH CROHN’S DISEASE. Program No. P1405. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.