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Nonalcoholic Fatty Liver Disease Increases Cardiovascular Risk in Inflammatory Bowel Diseases

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is strongly associated with cardiovascular disease in the general population. Both conditions seem more frequent in patients with inflammatory bowel disease (IBD). We aimed to assess the effect of NAFLD and liver fibrosis on intermediate–high card...

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Autores principales: Kablawi, Dana, Aljohani, Faisal, Palumbo, Chiara Saroli, Restellini, Sophie, Bitton, Alain, Wild, Gary, Afif, Waqqas, Lakatos, Peter L, Bessissow, Talat, Sebastiani, Giada
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9951742/
https://www.ncbi.nlm.nih.gov/pubmed/36846097
http://dx.doi.org/10.1093/crocol/otad004
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author Kablawi, Dana
Aljohani, Faisal
Palumbo, Chiara Saroli
Restellini, Sophie
Bitton, Alain
Wild, Gary
Afif, Waqqas
Lakatos, Peter L
Bessissow, Talat
Sebastiani, Giada
author_facet Kablawi, Dana
Aljohani, Faisal
Palumbo, Chiara Saroli
Restellini, Sophie
Bitton, Alain
Wild, Gary
Afif, Waqqas
Lakatos, Peter L
Bessissow, Talat
Sebastiani, Giada
author_sort Kablawi, Dana
collection PubMed
description BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is strongly associated with cardiovascular disease in the general population. Both conditions seem more frequent in patients with inflammatory bowel disease (IBD). We aimed to assess the effect of NAFLD and liver fibrosis on intermediate–high cardiovascular risk in IBD. METHODS: We prospectively included IBD patients undergoing a routine screening program for NAFLD by transient elastography (TE) with associated controlled attenuation parameter (CAP). NAFLD and significant liver fibrosis were defined as CAP ≥275 dB m(−1) and liver stiffness measurement by TE ≥8 kPa, respectively. Cardiovascular risk was assessed with the atherosclerotic cardiovascular disease (ASCVD) risk estimator and categorized as low if <5%, borderline if 5%–7.4%, intermediate if 7.5%–19.9%, and high if ≥20% or if previous cardiovascular event. Predictors of intermediate–high cardiovascular risk were investigated by multivariable logistic regression analysis. RESULTS: Of 405 patients with IBD included, 278 (68.6%), 23 (5.7%), 47 (11.6%), and 57 (14.1%) were categorized as at low, borderline, intermediate, and high ASCVD risk, respectively. NAFLD and significant liver fibrosis were found in 129 (31.9%) and 35 (8.6%) patients, respectively. After adjusting for disease activity, significant liver fibrosis and body mass index, predictors of intermediate–high ASCVD risk were NAFLD (adjusted odds ratio [aOR] 2.97, 95% CI, 1.56–5.68), IBD duration (aOR 1.55 per 10 years, 95% CI, 1.22–1.97), and ulcerative colitis (aOR 2.32, 95% CI, 1.35–3.98). CONCLUSIONS: Assessment of cardiovascular risk should be targeted in IBD patients with NAFLD, particularly if they have longer IBD duration and ulcerative colitis.
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spelling pubmed-99517422023-02-25 Nonalcoholic Fatty Liver Disease Increases Cardiovascular Risk in Inflammatory Bowel Diseases Kablawi, Dana Aljohani, Faisal Palumbo, Chiara Saroli Restellini, Sophie Bitton, Alain Wild, Gary Afif, Waqqas Lakatos, Peter L Bessissow, Talat Sebastiani, Giada Crohns Colitis 360 Observations and Research BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is strongly associated with cardiovascular disease in the general population. Both conditions seem more frequent in patients with inflammatory bowel disease (IBD). We aimed to assess the effect of NAFLD and liver fibrosis on intermediate–high cardiovascular risk in IBD. METHODS: We prospectively included IBD patients undergoing a routine screening program for NAFLD by transient elastography (TE) with associated controlled attenuation parameter (CAP). NAFLD and significant liver fibrosis were defined as CAP ≥275 dB m(−1) and liver stiffness measurement by TE ≥8 kPa, respectively. Cardiovascular risk was assessed with the atherosclerotic cardiovascular disease (ASCVD) risk estimator and categorized as low if <5%, borderline if 5%–7.4%, intermediate if 7.5%–19.9%, and high if ≥20% or if previous cardiovascular event. Predictors of intermediate–high cardiovascular risk were investigated by multivariable logistic regression analysis. RESULTS: Of 405 patients with IBD included, 278 (68.6%), 23 (5.7%), 47 (11.6%), and 57 (14.1%) were categorized as at low, borderline, intermediate, and high ASCVD risk, respectively. NAFLD and significant liver fibrosis were found in 129 (31.9%) and 35 (8.6%) patients, respectively. After adjusting for disease activity, significant liver fibrosis and body mass index, predictors of intermediate–high ASCVD risk were NAFLD (adjusted odds ratio [aOR] 2.97, 95% CI, 1.56–5.68), IBD duration (aOR 1.55 per 10 years, 95% CI, 1.22–1.97), and ulcerative colitis (aOR 2.32, 95% CI, 1.35–3.98). CONCLUSIONS: Assessment of cardiovascular risk should be targeted in IBD patients with NAFLD, particularly if they have longer IBD duration and ulcerative colitis. Oxford University Press 2023-02-02 /pmc/articles/PMC9951742/ /pubmed/36846097 http://dx.doi.org/10.1093/crocol/otad004 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Observations and Research
Kablawi, Dana
Aljohani, Faisal
Palumbo, Chiara Saroli
Restellini, Sophie
Bitton, Alain
Wild, Gary
Afif, Waqqas
Lakatos, Peter L
Bessissow, Talat
Sebastiani, Giada
Nonalcoholic Fatty Liver Disease Increases Cardiovascular Risk in Inflammatory Bowel Diseases
title Nonalcoholic Fatty Liver Disease Increases Cardiovascular Risk in Inflammatory Bowel Diseases
title_full Nonalcoholic Fatty Liver Disease Increases Cardiovascular Risk in Inflammatory Bowel Diseases
title_fullStr Nonalcoholic Fatty Liver Disease Increases Cardiovascular Risk in Inflammatory Bowel Diseases
title_full_unstemmed Nonalcoholic Fatty Liver Disease Increases Cardiovascular Risk in Inflammatory Bowel Diseases
title_short Nonalcoholic Fatty Liver Disease Increases Cardiovascular Risk in Inflammatory Bowel Diseases
title_sort nonalcoholic fatty liver disease increases cardiovascular risk in inflammatory bowel diseases
topic Observations and Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9951742/
https://www.ncbi.nlm.nih.gov/pubmed/36846097
http://dx.doi.org/10.1093/crocol/otad004
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