Liver Ultrasound Identifies High Prevalence of NAFLD in Patients With IBD

Liver cirrhosis. Computer illustration and light micrograph of a section through a human liver with cirrhosis-associated hepatocellular nodules.
Investigators assessed the incidence and clinical characteristics of liver diseases among patients with inflammatory bowel disease.

The following article is a part of conference coverage from the Advances in Inflammatory Bowel Diseases 2021 Annual Meeting , held from December 9 to 11, 2021. The team at Gastroenterology Advisor will be reporting on the latest news and research conducted by leading experts in gastroenterology. Check back for more from AIBD 2021.


Liver ultrasound showed a high prevalence of nonalcoholic fatty liver disease (NAFLD) in patients with inflammatory bowel disease (IBD), according to study results presented at the Advances in Inflammatory Bowel Diseases (AIBD) 2021 conference, held from December 9 to 11, 2021, in Orlando, Florida and virtually.

According to the researchers, hepatic diseases such as NAFLD and cirrhosis are some frequent complications found in patients with IBD. Noninvasive, low-cost ultrasonography could identify these hepatic manifestations at earlier stages, the researchers added.

In their cross-sectional study, a team of Brazilian investigators evaluated liver ultrasound findings from 71 patients (mean age, 45.32±13.59 years; 63.38% women) at a single IBD center. A total of 34 patients had Crohn disease (CD) and 37 patients had ulcerative colitis (UC). In addition to liver ultrasound, the researchers also evaluated patients’ clinical data, disease activity, and biochemical tests.

Patients with CD showed ileocolonic involvement (42.42%), penetrating behavior (50%), and perianal involvement (39.4%). The majority of patients with UC had pancolitis (72.22%).  Clinical remission was reported in 93.55% of patients with CD and 63.89% of patients with UC. Endoscopic remission was observed in 47.14% of patients.

Primary medications used in the overall IBD population included azathioprine (46.48%), infliximab (40.85%), salicylates (28.17%), corticosteroids (16.9%), and adalimumab (11.27%).

The investigators found NAFLD in 45.07% (n=32) of patients, according to ultrasound. In terms of severity of NAFLD, 40.63% of patients had mild NAFLD, 40.63% had moderate disease, and 18.75% had severe NAFLD. The researchers identified a significant association between liver steatosis and blunt liver edge (P <.0155).

A total of 2 patients had choledocholithiasis, while 1 patient showed features of chronic liver disease such as irregular surface, heterogeneity of a hepatic parenchymal echo, and bluntness of the liver edge. There were no reported signs of thrombosis in portal, splenic, or superior mesenteric veins.

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Daniel S, Marina L, Carolina DOA, et al. Investigation of liver diseases by ultrasound in patients with inflammatory bowel disease. Presented at: AIBD 2021 Annual Meeting; December 9-11, 2021; Orlando, FL and virtual. Abstract P049.