Increase in liver fibrosis in patients with inflammatory bowel disease at the inflammatory bowel disease clinic, Centro Medico Nacional 20 de noviembre

Introduction and Objective

To determine the progression to liver fibrosis secondary to non-alcoholic fatty liver disease (NAFLD) by non-invasive methods in patients with Inflammatory Bowel Disease (IBD).

Material and Methods

Descriptive, cross-sectional, and retrospective study. Variables analyzed: age, sex, type of IBD, treatment, Fibrosis-4 (FIB-4) and NAFLD fibrosis score (NFS). The SPSS version 25 program was used, with univariate analysis, 95% CI and significant P <0.05.

Results

Of 125 patients, 88 (70.4%) had chronic nonspecific ulcerative colitis (UC) and 37 (29.6%) had Crohn's disease (CD). NAFLD was found in 20 patients (16%), with fibrosis in 20% (4 patients), as well as cirrhosis (20%) without statistical significance (Table 1). Grade F0-F2 (NFS<1.455) was more frequent in both groups, with no significant correlation with IBD. Ustekinumab correlated with NAFLD without fibrosis (P<0.05), while mesalazine correlated significantly with liver fibrosis (F3-F4).

Discussion

NAFLD occurs in 50% of patients with IBD. The pathogenesis includes, on the one hand, the release of cytokines and adipokines that lead to increased inflammation and hepatic fibrosis and, on the other, altered intestinal permeability, with the consequent hepatic fatty infiltration. For its diagnosis, non-invasive tools were created, such as NFS and FIB-4, with the best predictive value for advanced liver fibrosis.

Conclusions

The occurrence of NAFLD and progression to fibrosis were significantly correlated with the treatment of the underlying disease.

Funding

The resources used in this study were from the hospital without any additional financing

Declaration of interest

The authors declare no potential conflicts of interest.

Table 1. Demographic characteristics of patients with inflammatory Bowel Disease