Meta-analysis: prevalence of, and risk factors for, non-alcoholic fatty liver disease in patients with inflammatory bowel disease
Mohammad Zamani
Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Student Research Committee, Babol University of Medical Sciences, Babol, Iran
Contribution: Conceptualization (equal), Data curation (equal), Formal analysis (equal), Investigation (equal), Methodology (equal), Writing - original draft (equal)
Search for more papers by this authorShaghayegh Alizadeh-Tabari
Student Research Committee, Babol University of Medical Sciences, Babol, Iran
Contribution: Conceptualization (equal), Data curation (equal), Writing - original draft (equal)
Search for more papers by this authorSiddharth Singh
Division of Gastroenterology, and Division of Biomedical Informatics, University of California San Diego, La Jolla, California, USA
Contribution: Conceptualization (equal), Methodology (equal), Writing - review & editing (equal)
Search for more papers by this authorCorresponding Author
Rohit Loomba
NAFLD Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA
Correspondence
Rohit Loomba, NAFLD Research Center, Professor of Medicine, Division of Gastroenterology; Adjunct Professor, Division of Epidemiology, University of California San Diego, 9452 Medical Center Drive, 1W202 ACTRI Building # MC0887, La Jolla, CA 92093-0887, USA.
Email: [email protected]
Contribution: Conceptualization (equal), Funding acquisition (equal), Methodology (equal), Supervision (equal), Writing - review & editing (equal)
Search for more papers by this authorMohammad Zamani
Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Student Research Committee, Babol University of Medical Sciences, Babol, Iran
Contribution: Conceptualization (equal), Data curation (equal), Formal analysis (equal), Investigation (equal), Methodology (equal), Writing - original draft (equal)
Search for more papers by this authorShaghayegh Alizadeh-Tabari
Student Research Committee, Babol University of Medical Sciences, Babol, Iran
Contribution: Conceptualization (equal), Data curation (equal), Writing - original draft (equal)
Search for more papers by this authorSiddharth Singh
Division of Gastroenterology, and Division of Biomedical Informatics, University of California San Diego, La Jolla, California, USA
Contribution: Conceptualization (equal), Methodology (equal), Writing - review & editing (equal)
Search for more papers by this authorCorresponding Author
Rohit Loomba
NAFLD Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA
Correspondence
Rohit Loomba, NAFLD Research Center, Professor of Medicine, Division of Gastroenterology; Adjunct Professor, Division of Epidemiology, University of California San Diego, 9452 Medical Center Drive, 1W202 ACTRI Building # MC0887, La Jolla, CA 92093-0887, USA.
Email: [email protected]
Contribution: Conceptualization (equal), Funding acquisition (equal), Methodology (equal), Supervision (equal), Writing - review & editing (equal)
Search for more papers by this authorAs part of AP&T’s peer review process, a technical check of this meta-analysis was performed by Dr Y Yuan. The Handling Editor for this article was Dr Stephen Ryder, and it was accepted for publication after full peer-review.
Funding information: RL receives funding support from NCATS (5UL1TR001442), NIDDK (U01DK061734, U01DK130190, R01DK106419, R01DK121378, R01DK124318, P30DK120515), NHLBI (P01HL147835) and NIAAA (U01AA029019). SS is supported by NIDDK K23DK117058 and R03DK129631.
Summary
Background
Non-alcoholic fatty liver disease (NAFLD) is found in inflammatory bowel disease (IBD). However, uncertainties remain on the magnitude of the association.
Aims
To explore systematically the prevalence of, and risk factors for, NAFLD in IBD patients.
Methods
We searched medical literature using Embase, PubMed, Web of Science, Scopus and ProQuest, from inception to September 30, 2021. We included observational studies reporting the prevalence of NAFLD in ≥50 adult patients with IBD. Diagnosis of NAFLD could be based on imaging, histopathology, and/or hepatic steatosis index. Sex, age, body mass index (BMI), diabetes, hypertension, dyslipidemia, prior surgery (bowel resection), corticosteroids, biologics and immunomodulators were assessed as potential risk factors for NAFLD.
Results
Of 1893 citations, 44 eligible studies were finally included, comprising 14 947 subjects from 18 different countries. Pooled prevalence of NAFLD was 30.7% (95% confidence interval [CI] 26.5–34.9) in patients with IBD worldwide, which varied regionally. No significant difference was observed in the odds ratio (OR) of NAFLD among Crohn’s disease (CD) patients compared with ulcerative colitis (UC) patients (1.16, 95% CI 0.93–1.44). Risk of NAFLD was almost twice as high in patients with IBD as in healthy subjects (OR 1.96, 95% CI 1.13–3.41). Age (adjusted OR 1.03, 95% CI 1.01–1.05) and BMI (adjusted OR 1.27, 95% CI 1.22–1.32) were statistically significantly associated with increased risk of NAFLD. The pooled prevalence of advanced liver fibrosis in IBD patients with NAFLD was 13.6% (95% CI 7.6–19.7) based on six studies.
Conclusion
Up to one-third of patients with IBD experienced NAFLD worldwide. The risk of NAFLD was two times higher in IBD patients versus healthy subjects.
Open Research
DATA AVAILABILITY STATEMENT
No additional data available.
Supporting Information
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