A199 SCREENING FOR NONALCOHOLIC FATTY LIVER DISEASE BY TRANSIENT ELASTOGRAPHY WITH CONTROLLED ATTENUATION PARAMETER IN UNSELECTED PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Nonalcoholic fatty liver disease (NAFLD) is the most frequent liver disease in North America. Patients with inflammatory bowel disease (IBD) are at risk for NAFLD due to chronic inflammation, hepatotoxic drugs, and alteration of gut microbiota. However, prospective data in unselected patients by means of validated and accurate diagnostic methods are lacking. We prospectively investigated prevalence and predictors of NAFLD and liver fibrosis by transient elastography (TE) with associated controlled attenuation parameter (CAP) in unselected IBD patients free of liver disease as part of a routine screening program. Any grade (involving >10% of hepatocytes), moderate (>30%) and severe (>60%) steatosis were defined as CAP ≥238, CAP ≥260 and CAP ≥292 dB/m, respectively. Significant liver fibrosis and cirrhosis (stage 2 and 4 out of 4, respectively) were defined as TE measurement ≥8 and ≥13 kPa. Active IBD was defined as partial Mayo score ≥3 and Harvey Bradshaw Index ≥5 for ulcerative colitis and Crohn’s disease, respectively. Predictors of any grade NAFLD and significant liver fibrosis were determined by logistic regression analysis. 317 patients (mean age 42.9, 48.8% male) were included; 65.9% had Crohn’s disease, and 28% had active disease at time of recruitment. Prevalence of any grade, moderate and severe steatosis was as follows: 39.7%, 32.6% and 19.8%, respectively. The prevalence of significant liver fibrosis and cirrhosis was 9.5% and 1.9%, respectively. Main predictors of NAFLD were older age, being overweight (BMI >25) and methotrexate use (Table1). The main predictors of significant liver fibrosis were prior IBD-related surgery, being overweight, dyslipidemic and on methotrexate. NAFLD diagnosed by TE with CAP is a major comorbidity in unselected IBD patients without known liver disease. These patients may also have significant liver fibrosis and cirrhosis, likely suggesting the coexistence of non-alcoholic steatohepatitis. Non-invasive screening strategies can help early diagnosis and initiation of interventions in this population, including weight loss, treatment of dyslipidemia and potentially drug regimen modification. Table 1. Multivariate analysis of predictors of NAFLD and fibrosis None