Analysis Of Influencing Factors Of IBD Combined With NAFLD And The Effect Of Infliximab On The Severity Of Hepatic Steatosis In Patients With IBD Combined With NAFLD

Background and Purpose:Patients with inflammatory bowel disease(IBD)are often accompanied by parenteral manifestations,in which hepatic steatopathy is a common hepatobiliary manifestation of IBD.However,there are few reports about inflammatory bowel disease complicated with fatty liver.IBD is often characterized by wasting and malnutrition,but studies have found that the prevalence of NAFLD is higher in patients with IBD than in the general population.IBD is closely associated with many pathogenesis of NAFLD.However,the mechanism and risk factors of IBD with NAFLD remain unclear,including the potential effect of anti-TNF-αbiologics on NAFLD.The purpose of this study was to analyze the risk factors of IBD patients with NAFLD in our hospital and the potential role of anti-TNF-αbiologics in the treatment of NAFLD.Method:A total of 637 patients diagnosed with CD and UC were included in the gastroenterology Department of China-Japan Union Hospital,Jilin University from January 1,2011 to December 31,2022,including 544 patients with UC and 93patients with CD.Among them,132 patients with IBD complicated with NAFLD(including 115 UC and 17 CD)were indicated by imaging such as color ultrasound,CT and non-invasive hepatic fibrosis detection.As the object of this study,32 patients were treated with anti-TNF-αbiological agents.The patients without NAFLD were selected as the control group and the simple IBD group.The analysis of risk factors related to IBD with NAFLD and the potential role of anti-TNF-αbiologics in the treatment of NAFLD were explored.Results:1.Age,BMI,combined hypertension,combined coronary heart disease,combined diabetes,history of small bowel resection,duration of disease,lesion site,ALT,AST,creatinine,cholesterol,erythrocyte sedimentation rate,and CHOL had significant differences between the IBD combined with NAFLD group and the pure IBD group Significant statistical difference.2.The difference in CAP values between the 18-35-year-old group and the60-year-old group was statistically significant;the difference between the BMI overweight group(24≤BMI<28 kg/m~2)and the BMI obese group(28kg/m~2≤BMI)CAP values? have significant statistical difference.3.There is a statistically significant difference in the CAP values between the moderate activity group and the severe activity group.4.After the 5th course of treatment(22nd week),the 8th course of treatment(46th week),and the 11th course of treatment(70th week)of the anti-TNF-αbiological agent infliximab in patients with UC and CD,IBD combined with NAFLD The degree of hepatic steatosis showed a downward trend.And the degree of fat change in CD patients was more obvious than that in UC patients.5.BMI,hypertension,diabetes,duration of disease,and ALT are independent risk factors for IBD combined with NAFLD.Conclusion:1.The etiology of IBD combined with NAFLD is relatively complex.Age,BMI,combined hypertension,combined coronary heart disease,combined diabetes,history of small bowel resection,duration of disease,lesion location,ALT,AST,creatinine,cholesterol,and erythrocyte sedimentation rate may all be IBD combined Risk factors for NAFLD.2.BMI,diabetes mellitus,duration of disease,and ALT are independent risk factors for IBD combined with NAFLD.3.The application of anti-TNF-αbiological agent infliximab may help to improve the degree of liver steatosis in IBD patients with NAFLD.