Duration of disease, body mass index (BMI), and liver enzymes are predictive of non-alcoholic fatty liver disease (NAFLD) in patients with Crohn’s disease, suggests a study reported in BMC Gastroenterology.¹

In this study, hospitalized patients with Crohn’s disease who underwent magnetic resonance enterography (MRE) at a hospital in Shanghai were enrolled between June 2018 and May 2020. Their medical records were reviewed to obtain data for age, gender, disease history, medication history, BMI, and lab tests.

Eighty-three (24.4%) of the 340 patients included were also diagnosed with NAFLD on magnetic resonance proton density fat fraction. These patients had had their disease for a longer duration (4 years vs 2 years) and were also likely to use steroids more frequently and have higher BMI (22.3 kg/m² vs 19.6 kg/m²) than those who did not have NAFLD. Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transpeptidase (GGT), and prealbumin were raised. No significant difference was found in the C-reactive protein (CRP) and albumin levels.

No difference in the occurrence of NAFLD was noted with anti-tumor necrosis factor-α (TNF-α) therapy for more than 54 weeks. However, BMI (odds ratios 2.37), ALT (OR 1.65), AST (OR 0.62), GGT (OR 1.26), prealbumin (OR 1.56), and disease duration were found to be predictive of hepatic steatosis on multivariate analysis.

This study highlights the high prevalence of coexisting NAFLD in patients with long-term Crohn’s disease. Early detection of fatty changes in the liver is crucial to prevent its progression to liver dysfunction and end-stage liver disease. Disease duration, BMI, and serum transaminases were identified as factors that could be used to determine the likelihood of occurrence of NAFLD in these patients.

Reference

1. Hong Q, et al. Prevalence and predictors of non-alcoholic liver disease on MRI among patients with Crohns disease. BMC Gastroenterol. 2022 Apr 12;22(1):183. doi: 10.1186/s12876-022-02238-5.