P0403 - Is There a Relationship Between NAFLD and Eosinophilic Esophagitis? Insights From the National Inpatient Sample

Kirti Arora, MBBS¹, Aalam Sohal, MD², Jay Patel, MD³, Ishandeep Singh, MBBS¹, Hunza Chaudhry, MD⁴, Isha Kohli, MBBS, CPH, MPH⁵, Dino Dukovic, BS⁶, Mukul Dhiman, MBBS⁷, Marina Roytman, MD^8
1Dayanand Medical College and Hospital, Ludhiana, Punjab, India; ²Liver Institute Northwest, Seattle, WA; ³Orange Park Medical Center, Jacksonville, FL; ⁴University of California San Francisco, Fresno, CA; ⁵Icahn School of Medicine at Mount Sinai, New York, NY; ⁶Ross University School of Medicine, Maramar, FL; ⁷Punjab Institute of Medical Sciences, Jalandhar, Kharar, Punjab, India; ⁸UCSF Fresno, Fresno, CA

Introduction: Eosinophilic esophagitis (EoE) is a chronic immune-mediated inflammatory condition. Non alcoholic fatty liver disease is associated with changes in the gut microbiota and has interplay with the body’s immune response. Interestingly, the risk factors for eosinophilic esophagitis are similar to those with NAFLD such as diabetes, obesity, inflammatory bowel disease and celiac disease. In this study, we aim to assess if an association exists between NAFLD and EoE.

Methods: National Inpatient Sample (NIS) database 2020 was used to stratify patients based on the presence of NAFLD. ICD-10 codes were used to identify patients with NAFLD and EoE. Information was collected regarding patient demographics, hospital characteristics, Charlson comorbidity index, coexisting comorbidities (GERD, hyperlipidemia, smoking, diabetes, hypertension, obesity, obstructive sleep apnea(OSA), inflammatory bowel disease (IBD), asthma, atopic dermatitis, celiac disease, mixed connective tissue disorders as well as irritable bowel syndrome (IBS)). Multivariate analysis was used to identify the relationship between NAFLD and EoE after adjusting for confounding factors.

Results: Out of 26 million patients, only 4,820 (0.018%) patients had EoE. The majority of the patients in the EoE group between 18 and 44 years of age (47.82%), male (54.05%), had private insurance (50.1%) and were in the highest income quartile (29.25%). There was a higher prevalence of EoE in patients with NAFLD than those without (6.1% vs 2.7%, p< 0.001). Patients with EoE had a higher prevalence of GERD, asthma, atopic dermatitis, celiac disease, mixed connective tissue disorder, and irritable bowel syndrome compared to patients without EoE (Table 1). On univariate analysis, a statistically significant positive association was noted between NAFLD/NASH and eosinophilic esophagitis ( aOR- 2.21,95% CI-1.70-2.88, p< 0.001 ). The association was noted to be stronger after adjusting for confounding factors ( aOR-2.53, 95% CI-1.93-3.32, p< 0.001) (Figure 1).

Discussion: Our study demonstrates a notable increase in the risk of EoE in patients with NAFLD. A previous study reported a trend towards increased risk of EoE in patients with NAFLD, however the results were not statistically significant due to smaller sample size.Using larger database, our suggests that an association exists between EoE and NAFLD. We hypothesize that immune changes in patients with NAFLD may contribute to the increased risk of EoE.




Disclosures:


Kirti Arora, MBBS¹, Aalam Sohal, MD², Jay Patel, MD³, Ishandeep Singh, MBBS¹, Hunza Chaudhry, MD⁴, Isha Kohli, MBBS, CPH, MPH⁵, Dino Dukovic, BS⁶, Mukul Dhiman, MBBS⁷, Marina Roytman, MD⁸. P0403 - Is There a Relationship Between NAFLD and Eosinophilic Esophagitis? Insights From the National Inpatient Sample, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.