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P773 Sarcopenia is a new risk factor of non-alcoholic fatty liver disease in patients with inflammatory bowel disease

B. I. Jang*1, K. O. Kim1,2, C. H. Yang3

1Yeungnam University College of Medicine, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Daegu, South Korea, 2Virginia Mason Medical Center, Digestive Disease Institute, Seattle, USA, 3Dongguk University College of Medicine, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyeongju, South Korea

Background

Although there has been known high association between metabolic syndrome (MS), and non-alcoholic fatty liver disease (NAFLD) in general population, MS is less frequent in patients with inflammatory bowel disease (IBD). Recently, sarcopenia has been proposed as an additional risk factor in patients with NAFLD, no study has been reported in patients with IBD. We aimed to analyse the clinical association between sarcopenia and NAFLD, independently other risk factors of NAFLD in patients with IBD.

Methods

From January 2004 to December 2017, total 488 IBD patients with the result of computed tomography (CT) were included in the analysis. Among them, we classified into non-NAFLD vs. NAFLD group and compared the clinical characteristics. The volume of muscle was calculated by area of total psoas muscle (TPA) in third lumbar region on CT per patient's height2 (m2). Sarcopenia was defined as the cases in which the volume of muscle less than 545 mm2/m2 in men and less than 385 mm2/m2 in women.

Results

NAFLD was diagnosed in 49 patients (11.1%) from final 443 IBD patients. Patients in NAFLD group were older (45.1 vs. 38.6 years; p = 0.006), had higher level of body mass index (23.0 ± 2.7 vs. 20.8 ± 3.3 kg/m2; p < 0.001), had higher proportions of ulcerative colitis (UC) (59.2% vs. 35.5%; p = 0.002), more metabolic syndrome (36.7% vs 7.4%; p < 0.001) than those in non-NAFLD group. Sarcopenia was more common in NAFLD group (51.0% vs. 33.0%; p = 0.019) than in non-NAFLD group. Sarcopenia was an independent risk factor for NAFLD in patients with IBD and the results was persistent after adjusting by age, gender, traditional metabolic risk factors, disease severity of IBD, and medication.

Conclusion

Our study showed that the prevalence of NAFLD in patients with IBD accounted for 11.1%. Along with other well-known, traditional risk factors, sarcopenia was also independent risk factor of NAFLD in patients with IBD. To prevent hepatic complication, physician need to consider carefully the nutrition, exercise and proper physical activity for maintaining sufficient muscle volume in patients with IBD.