P615. Ultrasonographic prevalence of liver steatosis in patients with inflammatory bowel disease in a single center
M. Di Girolamo1, A. Scarcelli1, A. Bertani1, A. Sartini1, A. Merighi1, E. Villa1, 1Policlinico Modena, Italy
In industrialized countries there is a progressive increase in the prevalence of non alcoholic fatty liver disease (NAFLD), non alcoholic steato-hepatitis (NASH) and metabolic syndrome. Inflammatory bowel diseases (IBD) are associated with alterations of liver. There is an increasing evidence of the active role played by adipose tissue as an endocrine system, producing local and systemic increased levels of many adipocyte-derived mediators involved in metabolic syndrome, which have immune-modulating capacities in IBD. On the other hand, the mesenteric fat hypertrophy and the ectopic fat surrounding inflamed bowel, the so-called creeping fat, are hallmarks of active disease. Ultrasonography (US) represents a non-invasive and well-tolerated diagnostic instrument to study liver and biliary tract. Few data exist about US liver changes in IBD patients in literature. In this preliminary retrospective study, we evaluated the prevalence of NAFLD in pts affected by IBD in a single centre.
All pts with a confirmed diagnosis of IBD who regularly attended to Gastroenterology Unit of University Hospital in Modena, Italy, underwent abdominal US. The pts have neither a previous history of liver disease (pre-existing acute or chronic hepatitis – viral, alcoholic, autoimmune, colestatic or drug-induced) nor viral serological markers of HBV/HCV infection.
From March 2006 to March 2012, a total of 128 IBD pts (16.25%), 94 with Crohn's disease and 34 with ulcerative colitis (UC) had an evidence of steatosis of different degrees: 37.5% mild, 12.5% mild-moderate, 32.8% moderate, 10.9% moderate to severe and 6.3% severe steatosis. We also observed a splenomegaly in 29 pts (22.65%) with an average diameter of the spleen equal to 10.36±1.64 cm and a mean area of approximately 46.09±10.92 cm. The average diameter of the portal vein was about 11.02±1.32 cm. All pts with steatosis were subjected to dietary therapy associated with physical aerobic activity.
Our preliminary data confirm a linkage between metabolic liver disease and IBD and suggest to evaluate the presence of a direct correlation of metabolic syndrome and intestinal disease activity, in term of diagnosis and therapy.