Prevalence of Hepatobiliary Manifestations in Inflammatory Bowel Disease: A GRADE Assessed Systematic Review and Meta-Analysis of more than 1.7 Million Patients

Abstract

Background and Aims Background: Inflammatory bowel disease (IBD) is an immune-mediated group of chronic gastrointestinal (GI) disorders. Patients with IBD may experience extraintestinal manifestations, such as the hepatobiliary complications. This meta-analysis aims to assess the prevalence of different hepatic manifestations in IBD patients. Methods For this systematic review and meta-analysis, PubMed, Scopus, Web of Science, and Embase were searched until July 20, 2022, by specifying keywords for IBD, hepatic manifestations, and study type. Full texts of cohort studies in English that examined the prevalence of different hepatic manifestations were included in this study. The primary outcome was the overall prevalence of hepatic manifestations in IBD patients. For the statistical analysis, a proportion by random effect model meta-analysis was performed. The registration number for the protocol of this study in PROSPERO is CRD42022369595. Results From the 4,421 articles retrieved from the primary search, 118 met the inclusion criteria and were included in the final analysis. After a pooled analysis of 1,729,128 patients, the overall prevalence of hepatic manifestations was 3.49% (95% CI: 3.31%-3.68%; I 2: 99.55%). The pooled prevalence of non-alcoholic fatty liver disease (NAFLD) in 228,216 patients was 26.1% (95% CI: 22.1–30.2%; I 2: 99.018%). After pooled analysis of 9,642 patients, the prevalence of primary sclerosing cholangitis (PSC) was 1.67% (95% CI: 1.47-1.88%; I 2: 99.10%). The pooled prevalence of biliary stones was considered to be 4.1% (95% CI: 3.6-4.7%; I 2: 97.43%). Autoimmune hepatitis [0.51% (95% CI: 0.26-0.75%; I 2: 85.36%)] and portal vein thrombosis (PVT) [0.21% (95% CI: 0.08-0.33%; I 2: 97.95%] are considered as rare manifestations. Conclusion This study summarizes the prevalence and importance of different hepatic manifestations in IBD patients. These findings are crucial for the management of EIMs, especially hepatic manifestations, in IBD patients.

Inflammatory bowel diseases: Transformation of representations. A review

“…(2023 г.) в систематическом обзоре с метаанализом данных более чем 1,7 млн пациентов указывают, что у 3,5% пациентов с ВЗК могут наблюдаться печеночные проявления различного характера [69].…”

“…По результатам последних исследований, распространенность неалкогольной жировой болезни печени у пациентов с ВЗК составляет от 21 до 32% [69]. Так, в очень крупном метаанализе M. Zamani и соавт.…”

Identification and validation of hub genes expressed in ulcerative colitis with metabolic dysfunction-associated steatotic liver disease

“…It is estimated that up to 26.1% of patients with IBD have concurrent MASLD. Among the patients with MASLD, the prevalence of UC was as high as 41.7% ( 7 ).…”

Gut Microbiota Profile Changes in Patients with Inflammatory Bowel Disease and Non-Alcoholic Fatty Liver Disease: A Metagenomic Study

“…The prevalence of NAFLD in the general population has increased significantly over time, from 25.5% before 2005 to 37.8% in 2016 or later [11]. A recent epidemiologic study investigating the occurrence of hepatobiliary conditions in IBD patients revealed a median 26% prevalence of NAFLD [12,13]. Crucially, patients with IBD exhibit an elevated rate of NAFLD diagnosis independent of traditional metabolic risk factors, such as obesity and diabetes [14].…”