Prevalência de doença hepática gordurosa não alcoólica em pacientes portadores de doença inflamatória intestinal

Abstract

Inflammatory bowel diseases (IBD) frequently present liver changes. The increase in the prevalence of non-hepatic fatty liver disease (NAFLD) has been widely reported in patients with IBD, and the mechanisms by which these two diseases are commonly associated remain unclear. NAFLD, currently recognized by the new nomenclature of Steatotic Liver Disease associated with Metabolic Dysfunction (MASLD), is defined by the presence of hepatic steatosis on imaging examination and at least one cardiometabolic risk factor. The objectives of the study were to evaluate the prevalence of NAFLD in patients with IBD and possible risk factors related to MASLD in these patients. A cross-sectional study was carried out on adults with IBD from January 2019 to December 2021. Patients with alcohol consumption > 20 g/d, those with other liver diseases or those using methotrexate were excluded. Clinicaldemographic data, characteristics inherent to IBD and liver profile were collected and expressed as frequency, mean and standard deviation. For the MASLD prediction models, binary logistic regression models were performed. 140 patients were included; 67.1% were female, with a mean age of 49.7 ± 13.7 years, and 63.6% had Crohn's disease. The mean duration of IBD was 9.7 ± 7.9 years. NAFLD was evident in 45% of patients and MASLD was observed in 44.3%. Advanced liver fibrosis was excluded in 63.5% by FIB-4. Patients with MASLD were older (p=0.003) and had a higher number of metabolic syndrome components (2.9 ± 1.1 versus 1.6 ± 1.0; p< 0.001), greater abdominal circumference (p< 0.001) and body mass index (p< 0.001). The only factor related to IBD associated with MASLD was disease duration (11.6 ± 9.5 versus 8.3 ± 6.2; p= 0.017). A higher number of MS components and obesity increase by 2.2 times and an altered waist circumference by 2.9 times the occurrence of MASLD. A high prevalence of MASLD was observed in patients with IBD, with the main risk factors associated with MS predicting it, not IBD features or its treatment.