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©The Author(s) 2020.
World J Gastroenterol. Dec 14, 2020; 26(46): 7367-7381
Published online Dec 14, 2020. doi: 10.3748/wjg.v26.i46.7367
Published online Dec 14, 2020. doi: 10.3748/wjg.v26.i46.7367
Table 1 Comparison of baseline characteristics between the subgroups of patients with nonalcoholic fatty liver disease versus those without nonalcoholic fatty liver disease in Crohn’s disease
Variable | NAFLD (n = 145) | No NAFLD (n = 157) | P value |
Male, n (%) | 75 (52) | 74 (47) | 0.495 |
Age at abdominal ultra sound (yr), median (IQR) | 49.0 (20.0) | 35.0 (19.0) | < 0.001c |
BMI (kg/m²), median (IQR) | 28.0 (7.6) | 23.0 (4.4) | < 0.001c |
Diabetes mellitus, n (%) | 7 (5) | 1 (1) | 0.057 |
Dyslipidemia, n (%) | 12 (8) | 3 (2) | 0.0131 |
Hypertension, n (%) | 50 (34) | 20 (13) | < 0.001c |
Current smoking, n (%) | 35 (24) | 29 (18) | 0.288 |
Smoking in the past, n (%) | 28 (19) | 31 (20) | 1.000 |
Smoking in general, n (%) | 63 (44) | 60 (38) | 0.420 |
HBI (IQR), n = 217 | 3.0 (5.0) | 1.0 (3.0) | < 0.001c |
HBI > 4, n (%), n = 217 | 46 (40) | 15 (15) | < 0.001c |
Inflammation in colonoscopy, n (%), n = 83 | 27 (61) | 20 (51) | 0.330 |
Inflammation in bowel ultrasound, n (%), n = 101 | 54 (82) | 47 (85) | 0.772 |
CRP, mg/L (IQR), n = 293 | 2.5 (7.0) | 3.0 (7.6) | 0.846 |
White blood cells, /nl (IQR), n = 293 | 7.8 (3.0) | 7.8 (2.8) | 0.737 |
Fecal calprotectin, µg/g (IQR), n = 172 | 111 (230) | 112 (249) | 0.638 |
γGT, U/l (IQR) | 24.0 (25.0) | 16 .0(16.5) | < 0.001c |
Elevated transaminases, n (%), n = 260 | 18 (16) | 9 (6) | 0.069 |
Disease duration at abdominal ultrasound (yr), median (IQR) | 16.0 (21.0) | 11.0 (12.0) | 0.002b |
History of bowel resection(s), n (%) | 72 (50) | 54 (45) | 0.010a |
Biological treatment at the time of ultrasound, n (%) | 104 (72) | 103 (66) | 0.308 |
Treatment with adalimumab at the time of ultrasound, n (%) | 53 (37) | 57 (36) | 0.767 |
Treatment with infliximab at the time of ultrasound, n (%) | 29 (20) | 21 (13) | 0.164 |
Treatment with vedolizumab at the time of ultrasound, n (%) | 11 (8) | 10 (6) | 0.850 |
Treatment with ustekinumab at the time of ultrasound, n (%) | 14 (10) | 18 (11) | 0.746 |
Treatment with azathioprine at the time of ultrasound, n (%) | 19 (13) | 18 (11) | 0.796 |
Treatment with budesonide at the time of ultrasound, n (%) | 7 (5) | 12 (8) | 0.576 |
Treatment with systemic steroids < 7.5 mg at the time of ultrasound, n (%) | 6 (4) | 8 (5) | 0.903 |
Treatment with systemic steroids > 7.5 mg at the time of ultrasound, n (%) | 10 (7) | 15 (10) | 0.530 |
Treatment with systemic steroids at the time of ultrasound, n (%) | 14 (10) | 21 (13) | 0.407 |
Treatment with mesalazine at the time of ultrasound, n (%) | 25 (17) | 19 (12) | 0.271 |
Treatment with sulfasalazine at the time of ultrasound, n (%) | 13 (9) | 3 (2) | 0.013a |
Table 2 Results from multivariable logistic regression model (backwards elimination) to identify risk factors for nonalcoholic fatty liver disease in Crohn’s disease patients
Parameter | Odds ratio | 95%CI | P value |
Intercept | < 0.01 | < 0.01; < 0.01 | < 0.001c |
Elevated HBI | 3.80 | 1.75-8.70 | 0.001b |
Age at abdominal ultrasound (yr) | 1.05 | 1.02-1.08 | < 0.001c |
BMI (kg/m²) | 1.25 | 1.15-1.37 | < 0.001c |
History of bowel resection(s) | 1.47 | 0.74-2.92 | 0.274 |
Hypertension | 0.81 | 0.31-2.09 | 0.668 |
Current smoking | 1.17 | 0.51-2.69 | 0.707 |
Dyslipidemia | 3.48 | 0.52-39.13 | 0.245 |
Table 3 Number of abdominal ultrasound examinations per patient
Ultrasound examinations (n) | CD patients | UC patients |
1 | 119 | 83 |
2 | 62 | 50 |
3 | 57 | 31 |
4 | 53 | 21 |
5 | 48 | 14 |
6 | 37 | 9 |
7 | 24 | 14 |
8 | 17 | 17 |
9 | 14 | 7 |
10 | 4 | 13 |
11 | 2 | 3 |
12 | 2 | 1 |
Table 4 Results of mixed model analysis to identify factors associated with nonalcoholic fatty liver disease in Crohn’s disease patients
Confounder model | |||
Variable | Estimate | 95%CI | P value |
Female sex | 0.70 | 0.09-1.31 | 0.293 |
Age at abdominal ultrasound (in years) | 1.07 | 1.04-1.09 | < 0.001c |
BMI at abdominal ultrasound (in years) | 1.32 | 1.30-1.34 | < 0.001c |
Diabetes mellitus | 2.36 | 0.11-4.61 | 0.509 |
Hypertension | 0.78 | -0.07-1.62 | 0.586 |
Dyslipidemia | 10.82 | 8.85-12.80 | 0.049a |
Current smoking | 1.91 | 1.28-2.53 | 0.109 |
Steroid use | 0.74 | 0.27-1.21 | 0.287 |
Parameters included in model with age and BMI | |||
Elevated HBI | 2.99 | 2.41-3.58 | < 0.001c |
Inflammation in colonoscopy | 16.40 | 14.59-18.11 | 0.002b |
Inflammation in bowel ultrasound | 1.46 | 1.30-1.61 | 0.344 |
Elevated CRP concentration | 1.17 | 1.01-1.33 | 0.502 |
Elevated white blood cell count | 0.96 | 0.10-1.12 | 0.295 |
Elevated fecal calprotectin concentration | 1.34 | 1.19-1.50 | 0.455 |
History of bowel resection(s) | 2.03 | 1.42-2.64 | 0.023a |
Biologic treatment | 1.01 | 0.85-1.17 | 0.959 |
Adalimumab treatment | 1.09 | 0.93-1.25 | 0.709 |
Infliximab treatment | 1.64 | 1.48-1.79 | 0.135 |
Vedolizumab treatment | 1.40 | 1.24-1.56 | 0.523 |
Ustekinumab treatment | 1.13 | 0.01-2.25 | 0.833 |
Golimumab treatment | 1.34 | 1.19-1.50 | 0.874 |
Azathioprine therapy | 1.98 | 1.36-2.61 | 0.031a |
Methotrexate treatment | 1.15 | 0.99-1.30 | 0.843 |
6-Mercaptopurine treatment | 1.08 | 0.92-1.24 | 0.940 |
Sulfasalazine treatment | 0.53 | 0.38-0.69 | 0.310 |
Mesalazine treatment | 1.14 | 0.98-1.29 | 0.688 |
Table 5 Comparison of baseline characteristics between the subgroups of patients with nonalcoholic fatty liver disease versus those without nonalcoholic fatty liver disease in ulcerative colitis
Variable | NAFLD (n = 68) | No NAFLD (n = 85) | P value |
Male, n (%) | 40 (59) | 37 (44) | 0.086 |
Age at abdominal ultrasound (yr), median (IQR) | 48.5 (18.5) | 37.0 (21.0) | 0.005b |
BMI (kg/m²), median (IQR) | 28.0 (5.7) | 22.8 (5.3) | < 0.001c |
Diabetes mellitus, n (%) | 6 (9) | 1 (1) | 0.057 |
Dyslipidemia, n (%) | 2 (3) | 2 (2) | 1.000 |
Hypertension, n (%) | 22 (32) | 6 (7) | < 0.001c |
Current smoking, n (%) | 4 (6) | 1 (1) | 0.242 |
Smoking in the past, n (%) | 20 (30) | 11 (13) | 0.021a |
Smoking in general, n (%) | 24 (35) | 12 (14) | 0.004b |
SCCAI (IQR), n = 124 | 2.0 (4.0) | 1.0 (3.0) | 0.253 |
SCCAI > 4, n (%), n = 124 | 14 (24) | 9 (14) | 0.156 |
Inflammation in colonoscopy, n (%), n = 45 | 15 (60) | 9 (45) | 0.123 |
Inflammation in bowel ultrasound, n (%), n = 28 | 10 (91) | 15 (88) | 0.812 |
CRP, mg/l (IQR), n = 146 | 2.9 (8.0) | 1.0 (5.1) | 0.114 |
White blood cells, /nl (IQR), n = 147 | 7.5 (2.9) | 7.0 (3.2) | 0.300 |
Fecal calprotectin, µg/g (IQR), n = 87 | 103 (390) | 147 (359) | 0.612 |
γGT, U/l (IQR) | 23.0 (40.0) | 18.0 (25.0) | 0.007b |
Elevated transaminases, n (%), n = 147 | 8 (13) | 7 (8) | 0.387 |
Disease duration at abdominal ultrasound (yr), median (IQR) | 9.0 (12.5) | 10.0 (30.5) | 0.408 |
History of bowel resection(s), n (%) | 6 (9) | 12 (14) | 0.449 |
Biological treatment at the time of ultrasound, n (%) | 33 (49) | 52 (61) | 0.161 |
Treatment with adalimumab at the time of ultrasound, n (%) | 8 (12) | 13 (15) | 0.694 |
Treatment with infliximab at the time of ultrasound, n (%) | 7 (10) | 20 (24) | 0.055 |
Treatment with vedolizumab at the time of ultrasound, n (%) | 19 (28) | 19 (22) | 0.544 |
Treatment with azathioprine at the time of ultrasound, n (%) | 13 (19) | 14 (16) | 0.831 |
Treatment with budesonide at the time of ultrasound, n (%) | 3 (4) | 3 (4) | 1.000 |
Treatment with systemic steroids < 7.5 mg at the time of ultrasound, n (%) | 7 (10) | 5 (6) | 0.480 |
Treatment with systemic steroids > 7.5 mg at the time of ultrasound, n (%) | 10 (15) | 12 (14) | 1.000 |
Treatment with systemic steroids at the time of ultrasound, n (%) | 13 (19) | 16 (19) | 1.000 |
Treatment with mesalazine at the time of ultrasound, n (%) | 42 (62) | 42 (49) | 0.173 |
Treatment with sulfasalazine at the time of ultrasound, n (%) | 2 (3) | 5 (6) | 0.634 |
Table 6 Results from multivariable logistic regression model (backwards elimination) to identify risk factors for nonalcoholic fatty liver disease in ulcerative colitis patients
Table 7 Results from multivariable logistic regression model (backwards elimination) to identify risk factors for nonalcoholic fatty liver disease in ulcerative colitis patients
Confounder model | |||
Variable | Estimate | 95%CI | P value |
Female sex | 0.62 | 0.50-0.65 | 0.159 |
Age at ultrasound (in years) | 0.99 | 0.98-1.03 | 0.637 |
BMI at ultrasound (in years) | 1.28 | 0.71-1.85 | < 0.001c |
Diabetes mellitus | 2.14 | 0.95-4.79 | 0.441 |
Hypertension | 2.89 | 2.51-4.10 | 0.037a |
Dyslipidemia | 1.46 | 0.98-2.84 | 0.695 |
Current smoking | 1.77 | 1.26-2.40 | 0.525 |
Steroid use | 0.88 | 0.20-1.54 | 0.652 |
Parameters included in model with age and BMI | |||
Elevated SCCAI | 1.58 | 1.42-1.74 | 0.145 |
Inflammation in colonoscopy | 3.60 | 2.69-4.50 | 0.005b |
Inflammation in bowel ultrasound | 2.31 | 2.16-2.47 | 0.162 |
Elevated CRP concentration | 0.99 | 0.83-1.14 | 0.959 |
Elevated white blood cell count | 1.01 | 0.85-1.17 | 0.782 |
Elevated fecal calprotectin concentration | 1.06 | 0.90-1.22 | 0.923 |
History of bowel resection(s) | 1.66 | 1.50-1.82 | 0.332 |
Biologic treatment | 0.69 | 0.53-0.85 | 0.167 |
Adalimumab treatment | 0.74 | 0.58-0.90 | 0.426 |
Infliximab treatment | 0.77 | 0.62-0.93 | 0.484 |
Vedolizumab treatment | 1.14 | 0.98-1.30 | 0.739 |
Ustekinumab treatment | 0.19 | 0.03-0.35 | 0.407 |
Golimumab treatment | 1.14 | 0.98-1.30 | 0.892 |
Azathioprine therapy | 1.19 | 1.03-1.35 | 0.597 |
Methotrexate treatment | 1.50 | 1.34-1.66 | 0.734 |
6-Mercaptopurine treatment | 0.94 | 0.79-1.10 | 0.947 |
Sulfasalazine treatment | 1.43 | 1.27-1.58 | 0.491 |
Mesalazine treatment | 0.88 | -0.25-2.00 | 0.635 |
- Citation: Hoffmann P, Jung V, Behnisch R, Gauss A. Prevalence and risk factors of nonalcoholic fatty liver disease in patients with inflammatory bowel diseases: A cross-sectional and longitudinal analysis. World J Gastroenterol 2020; 26(46): 7367-7381
- URL: https://www.wjgnet.com/1007-9327/full/v26/i46/7367.htm
- DOI: https://dx.doi.org/10.3748/wjg.v26.i46.7367