Worsening nutritional status in non-obese patients with inflammatory bowel disease is reflected by nonalcoholic fatty liver disease: a retrospective study

Abstract

Aim The frequency and details of nonalcoholic fatty liver disease (NAFLD) complications in patients with inflammatory bowel disease (IBD) remain unclear. This study aimed to clarify characteristics of NAFLD in non-obese patients with IBD. Methods Patients with IBD who underwent abdominal computed tomography (CT) examination at our hospital between 2005 and 2020 were retrospectively identified and enrolled in the study. The primary endpoint was the complication rate of NAFLD in patients with IBD. Secondary endpoints were the clinical characteristics of patients with IBD and comorbid NAFLD and their association with nutritional and inflammatory parameters. Results Twenty-one (21.9%) of 96 eligible patients with IBD also had NAFLD. In non-obese patients (defined as patients with a body mass index < 25 kg/m2), CRP (P < 0.0001) and alanine aminotransferase (P = 0.0183) levels were higher and the albumin level (P = 0.0046) and prognostic nutritional index (PNI; P = 0.0022) values were lower in patients with NAFLD than in those without NAFLD. The PNI value was positively correlated (P = 0.0001) and the CRP level was negatively correlated (P = 0.0008) with the hepatosplenic ratio. However, the PNI (P < 0.05) and CRP level (P < 0.001) improved numerically over time after computed tomography in the group with NAFLD than in the group without NAFLD. Conclusions Worsening nutritional status may be an indicator of NAFLD in patients with IBD. Diagnosis of NAFLD on CT imaging might be useful in patients with IBD not only for early detection of NAFLD but also for assessment of the need for therapeutic intervention for IBD.