Introduction
Non-alcoholic fatty liver disease (NAFLD) has become a significant global health issue, with its prevalence rapidly increasing worldwide. Recent studies indicate that individuals with inflammatory bowel disease (IBD) are at a higher risk of developing NAFLD compared to the general population. This systematic review and meta-analysis aim to assess the prevalence of NAFLD among IBD patients and identify associated risk factors.
Methods
The review involved a comprehensive search of the PubMed and Medline databases for relevant literature published between January 2014 and April 2024. The search criteria were designed to include a wide range of studies investigating the link between IBD and NAFLD. After an initial screening process, studies that did not meet the predefined eligibility criteria were excluded. The final analysis included 26 studies, representing over 429,550 IBD patients.
Results
The meta-analysis revealed that the overall prevalence of NAFLD among IBD patients was 34%, with a 95% confidence interval ranging from 27% to 41%. This prevalence is significantly higher than the estimated global prevalence of NAFLD, which is around 25.24%. The study also identified several risk factors associated with an increased likelihood of NAFLD in IBD patients, including prolonged illness duration, obesity, and metabolic syndrome characteristics.
Discussion
The relationship between NAFLD and IBD is complex and not fully understood. Factors such as genetic predispositions, environmental influences, and immune system imbalances play a crucial role in the coexistence of these conditions. While obesity is a common factor, some IBD patients with NAFLD may belong to the “lean NAFLD” group, indicating that underweight individuals can also be affected.
Previous studies on the link between IBD and NAFLD have been limited by small sample sizes and single-institution research. This systematic review and meta-analysis provide a more comprehensive estimation of NAFLD prevalence among IBD patients and highlight the need for further research to elucidate the underlying mechanisms.
Conclusion
The prevalence of NAFLD among IBD patients is notably higher than in the general population, emphasizing the need for targeted screening and management strategies. Understanding the relationship between these two conditions could lead to improved preventative measures and treatment options, ultimately enhancing the quality of life for affected individuals.
Recommendations
For high-risk IBD patients, regular screening for NAFLD using transient elastography combined with controlled attenuation parameter is recommended. This approach can help assess the degree of hepatic steatosis and fibrosis, allowing for early detection and management of NAFLD. Additionally, the impact of medications, such as corticosteroids and anti-TNF drugs, on NAFLD risk should be closely monitored.
Limitations
The study acknowledges significant heterogeneity among the included studies, which may affect the comparability of results. Future research should aim to adopt more standardized diagnostic methods to reduce heterogeneity and improve the reliability of findings.
Future Directions
Further studies are needed to explore the interactions between metabolic factors, systemic inflammation, gut microbiota dysbiosis, and malnutrition in the pathogenesis of NAFLD in IBD patients. A multidisciplinary approach involving gastroenterologists, hepatologists, and dietitians is essential for optimizing the management of patients with both IBD and NAFLD.
🔗 **Fuente:** https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1517462/full