L W Y Thin1, I C Lawrance2, K Spilsbury3, J Kava4, J K Olynyk5. 1. Centre for Inflammatory Bowel Diseases, Fremantle Hospital, Fremantle, WA, Australia; Department of Gastroenterology, Fremantle Hospital, Fremantle, WA, Australia. 2. Centre for Inflammatory Bowel Diseases, Fremantle Hospital, Fremantle, WA, Australia; University Department of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, WA, Australia; Department of Gastroenterology, Fremantle Hospital, Fremantle, WA, Australia. Electronic address: ian.lawrance@uwa.edu.au. 3. Centre for Population Health Research, Curtin University, Bentley, WA, Australia. 4. Department of Gastroenterology, Fremantle Hospital, Fremantle, WA, Australia. 5. Department of Gastroenterology, Fremantle Hospital, Fremantle, WA, Australia; Curtin Health Innovation Research Institute, Curtin University, Bentley, WA, Australia; Institute for Immunology & Infectious Diseases, Murdoch University, Murdoch, WA, Australia.
Abstract
BACKGROUND: Up to 5% of inflammatory bowel disease (IBD) patients are thought to have clinically significant liver disease due to multifactorial causes, however, this figure may be an underestimate due to reliance on abnormal liver tests (LTs) and/or liver biopsies. AIMS: Our aim was to evaluate the prevalence of clinically significant liver disease in IBD patients as defined by an increased liver stiffness measurement (LS) ≥8kPa using transient elastography (TE). METHODS: 110 IBD patients, and 55 non-IBD control subjects, had their LS recorded using FibroScan® (EchoSense, Paris, France) by a single blinded operator trained in TE. RESULTS: 71 Crohn's disease and 39 ulcerative colitis subjects were included. All demographic variables were similar between the IBD and control groups apart from a significantly higher proportion of IBD patients who smoked (17.3% vs 3.6%, P=0.013). Seven IBD patients (6.4%) had an LS over 8 kPa and 3 had persistently elevated LS 6 months later. One patient had compensated cirrhosis. No significant differences in overall LS were observed between the IBD and control groups. Increased BMI and age, however, were independently associated with a higher LS in the IBD but not in the control group (P<0.001 and 0.010 respectively). CONCLUSION: Using TE, the prevalence of clinically significant liver disease in IBD patients is low. The association of increased BMI and age with increased LS in IBD suggests fatty liver disease being the prevailing aetiology in these patients.
BACKGROUND: Up to 5% of inflammatory bowel disease (IBD) patients are thought to have clinically significant liver disease due to multifactorial causes, however, this figure may be an underestimate due to reliance on abnormal liver tests (LTs) and/or liver biopsies. AIMS: Our aim was to evaluate the prevalence of clinically significant liver disease in IBDpatients as defined by an increased liver stiffness measurement (LS) ≥8kPa using transient elastography (TE). METHODS: 110 IBDpatients, and 55 non-IBD control subjects, had their LS recorded using FibroScan® (EchoSense, Paris, France) by a single blinded operator trained in TE. RESULTS: 71 Crohn's disease and 39 ulcerative colitis subjects were included. All demographic variables were similar between the IBD and control groups apart from a significantly higher proportion of IBDpatients who smoked (17.3% vs 3.6%, P=0.013). Seven IBDpatients (6.4%) had an LS over 8 kPa and 3 had persistently elevated LS 6 months later. One patient had compensated cirrhosis. No significant differences in overall LS were observed between the IBD and control groups. Increased BMI and age, however, were independently associated with a higher LS in the IBD but not in the control group (P<0.001 and 0.010 respectively). CONCLUSION: Using TE, the prevalence of clinically significant liver disease in IBDpatients is low. The association of increased BMI and age with increased LS in IBD suggests fatty liver disease being the prevailing aetiology in these patients.
Authors: Tracey G Simon; Kimberley W J Van Der Sloot; Samantha B Chin; Amit D Joshi; Paul Lochhead; Ashwin N Ananthakrishnan; Ramnik Xavier; Raymond T Chung; Hamed Khalili Journal: Inflamm Bowel Dis Date: 2018-09-15 Impact factor: 5.325
Authors: Alisa Likhitsup; Jason Dundulis; Shaya Ansari; Sruthi Patibandla; Colleen Hutton; Kevin Kennedy; John H Helzberg; Rajiv Chhabra Journal: Ann Gastroenterol Date: 2019-07-22
Authors: Che-Yung Chao; Robert Battat; Alex Al Khoury; Sophie Restellini; Giada Sebastiani; Talat Bessissow Journal: World J Gastroenterol Date: 2016-09-14 Impact factor: 5.742