P3826 - The Impact of Nonalcoholic Fatty Liver Disease on Inflammatory Bowel Disease-Related Hospitalization Outcomes: A Systematic Review

Antoine Boustany, MD, MPH¹, Romy Rahhal, MD², Jad Mitri, MD³, Somtochukwu Onwuzo, MD⁴, Hadi Khaled Abou Zeid, MD⁵, György Baffy, MD, PhD⁶, Myriam Martel, MS⁷, Alan Barkun, MD, MSc⁸, Imad Asaad, MD^1
1Cleveland Clinic Foundation, Cleveland, OH; ²American University of Beirut, Beirut, Beyrouth, Lebanon; ³St. Elizabeth's Medical Center, Boston, MA; ⁴Cleveland Clinic Foundation, Fairview Park, OH; ⁵University of Balamand, Beirut, Beyrouth, Lebanon; ⁶Boston University Medical Center, Boston, MA; ⁷McGill University Hospital, Montreal, PQ, Canada; ⁸McGill University and McGill University Health Centre, Montreal, PQ, Canada

Introduction: Nonalcoholic fatty liver disease (NAFLD) has been the subject of intensive research efforts as it has become the most common liver disease worldwide. Evidence suggests that patients with inflammatory bowel disease (IBD) are at higher risk of developing NAFLD. However, there is limited information currently available on how NAFLD may affect the clinical course of IBD. The aim of this systematic review is to characterize the association of NAFLD on IBD-related hospitalization outcomes in patients afflicted by both conditions (NAFLD+IBD).

Methods: All observational studies assessing IBD-related hospitalization outcomes in patients with NAFLD were included. Studies with both inpatient or outpatient data were included in the systematic review but analyzed separately. Exclusion criteria were studies published in languages other than English or French, or those involving pediatric population. For studies involving inpatients, primary outcomes were IBD-related hospitalization length of stay, need for surgery, readmission rates, inpatient mortality, and hospitalization costs. For studies involving patients initially followed as outpatients, primary outcomes also included IBD-related hospitalization rates.

Results: Overall, 3,252 citations were retrieved and seven studies met the inclusion criteria (1,574,937 patients) (Figure 1); all were observational, of high quality, and originated in the United Sates. Measurable outcomes reported in these studies were few and with insufficient similarity across studies to complete a quantitative assessment. Only one study reports NAFLD severity. Two studies suggested a higher rate of hospitalization for patients with both NAFLD and IBD compared to IBD alone (incidence rate ratio of 1.54; 95% CI: 1.33-1.79) (Table 1).

Discussion: This is the first systematic review to date that evaluates any possible association of NAFLD with IBD-related hospitalization outcomes. Despite the paucity and low quality of available data, our findings indicate that NAFLD may be associated with worse outcomes amongst IBD patients (especially Crohn’s disease). Besides metabolic risk factors common for both diseases, specific IBD-related mechanisms hypothesized to explain this association include micronutrient deficiencies, total parenteral nutrition after bowel resections, and chronic use of IBD medications. Further and higher certainty of evidence is needed for better characterization of such clinical impact.



Disclosures:


Antoine Boustany, MD, MPH¹, Romy Rahhal, MD², Jad Mitri, MD³, Somtochukwu Onwuzo, MD⁴, Hadi Khaled Abou Zeid, MD⁵, György Baffy, MD, PhD⁶, Myriam Martel, MS⁷, Alan Barkun, MD, MSc⁸, Imad Asaad, MD¹. P3826 - The Impact of Nonalcoholic Fatty Liver Disease on Inflammatory Bowel Disease-Related Hospitalization Outcomes: A Systematic Review, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.