Original Article

The Correlation Between Liver Fat Content and Ulcerative Colitis Disease Severity

Abstract

To evaluate the association between disease severity and hepatic steatosis in patients with ulcerative colitis (UC) and non-alcoholic steatohepatitis (NASH). Consecutively selected UC patients admitted to the gastroenterology clinic were enrolled in the study. UC severity was assessed by Truelove and Witts classification. Patients with severe UC were excluded from the study. NASH was determined based on persistently elevated serum aminotransferase levels and detection of fatty liver ultrasound. Patients with other etiologies for elevated aminotransferase levels were excluded. Liver fat content (LFC) was assessed by measuring liver fat score (LFS). One hundred patients (42% male) were included in the study. According to liver ultrasound examination, 62 (%) patients were identified with grade 1 fatty liver disease, and 38 (%) patients were classified as advanced (grade 2 and 3) fatty liver disease. Sixty-one patients had left-sided UC and (46%) had mild UC disease severity index. LFS was significantly higher in UC patients with the moderate disease than patients with mild disease (3.53±2.68 vs. 5.89±2.85, respectively; P<0.01). Nevertheless, no significant difference was observed in LFS regarding UC extension. There was no significant difference between NASH ultrasound grades in view of UC severity and extension. LFC might be associated with UC severity.

Gómez-Gómez GJ, Masedo A, Yela C, Martínez-Montiel MP, Casís B. Current stage in inflammatory bowel disease: What is next? World J Gastroenterol, 2015; 21: 11282-303. [PMID: 26525013 / DOI: 10.3748/wjg.v21.i40.11282.]

------------------------------------------------------------------------------------

Jamali R. Non-Alcoholic Fatty Liver Disease: Diagnosis and Evaluation of Disease Severity. Thrita. 2013; 2: 43-51. [DOI: 10.5812/thrita.11795.]

------------------------------------------------------------------------------------

Jamali R, Hatami N, Kosari F. The Correlation Between Serum Adipokines and Liver Cell Damage in Non-Alcoholic Fatty Liver Disease. Hepat Mon. 2016; 16: e37412. [PMID: 27313636 / DOI: 10.5812/hepatmon.37412.]

------------------------------------------------------------------------------------

Stanford FC, Kyle TK. Obesity Education Beyond Nutrition Education: Thinking Farther Outside the Box. Acad Med. 2016; 91:164. [PMID: 26813650 / DOI: 10.1097/ACM.0000000000001041.]

------------------------------------------------------------------------------------

Zimmermann MB, Gübeli C, Püntener C, Molinari L. Detection of overweight and obesity in a national sample of 6-12-y-old Swiss children: accuracy and validity of reference values for body mass index from the US Centers for Disease Control and Prevention and the International Obesity Task Force. Am J Clin Nutr. 2004; 79: 838-43. [PMID: 15113723]

------------------------------------------------------------------------------------

Jamali R, Khonsari M, Merat S, Khoshnia M, Jafari E, Bahram Kalhori A, Abolghasemi H, Amini S, Maghsoudlu M, Deyhim MR. Persistent alanine aminotransferase elevation among the general Iranian population: prevalence and causes. World J Gastroenterol. 2008; 14:2867-2871. [PMID: 18473412]

------------------------------------------------------------------------------------

Ahmed M. Non-alcoholic fatty liver disease in 2015. World J Hepatol. 2015; 7:1450-1459. [PMID: 26085906 / DOI: 10.4254/wjh.v7.i11.1450.]

------------------------------------------------------------------------------------

Marchesini G, Bugianesi E, Forlani G, Cerrelli F, Lenzi M, Manini R, Natale S, Vanni E, Villanova N, Melchionda N, Rizzetto M. Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome. Hepatology. 2003; 37: 917-923. [PMID: 12668987 / DOI: 10.1053/jhep.2003.50161]

-----------------------------------------------------------------------------------

Azzam H, Malnick S. Non-alcoholic fatty liver disease - the heart of the matter. World J Hepatol. 2015; 7: 1369-76. [PMID: 26052382 / DOI: 10.4254/wjh.v7.i10.1369.]

------------------------------------------------------------------------------------

Abd El-Kader SM, El-Den Ashmawy EM. Non-alcoholic fatty liver disease: The diagnosis and management. World J Hepatol. 2015; 7: 846-58. [PMID: 25937862 / DOI: 10.4254/wjh.v7.i6.846.]

------------------------------------------------------------------------------------

Yoon HJ, Cha BS. Pathogenesis and therapeutic approaches for non-alcoholic fatty liver disease. World J Hepatol. 2014; 6: 800-11. [PMID: 25429318/ DOI: 10.4254/wjh.v6.i11.800.]

-----------------------------------------------------------------------------------

Goncalves P, MagroF, Martelv F. Metabolic Inflammation in Inflammatory Bowel Disease: Crosstalk Between Adipose Tissue and Bowel. Inflamm Bowel Dis. 2015; 21:453–467. [PMID: 25248003 / DOI: 10.1097/MIB.0000000000000209]

----------------------------------------------------------------------------------

Sourianarayanane A, Garg G, Smith TH, Butt MI, Mc-Cullough AJ, Shen B. Risk factors of non-alcoholic fatty liver disease in patients with inflammatory bowel disease. J Crohns Colitis. 2013; 7: e279-85. [PMID: 23158500 / DOI: 10.1016/j.crohns.2012.10.015.]

-----------------------------------------------------------------------------------

Hirten R, Sultan K, Thomas A, Bernstein DE. Hepatic manifestations of nonsteroidal inflammatory bowel disease therapy. World J Hepatol. 2015; 7: 2716–2728. [PMID: 26644815 / DOI: 10.4254/wjh.v7.i27.2716]

------------------------------------------------------------------------------------

Navaneethan U, Shen B. Hepatopancreatobiliary manifestations and complications associated with inflammatory bowel disease. Inflamm Bowel Dis. 2010; 16:1598-619. [PMID: 20198712 / DOI: 10.1002/ibd.21219.]

------------------------------------------------------------------------------------

McGowan CE, Jones, P, Long MD, Barritt S. The Changing Shape of Disease: Non-alcoholic Fatty Liver Disease in Crohn's Disease A case series and review of the literature. Inflamm Bowel Dis. 2012; 18: 49–54. [PMID: 21351214 / DOI: 10.1002/ibd.21669]

------------------------------------------------------------------------------------

Bischoff SC, Barbara G, Buurman W, Ockhuizen T, Schulzke JD, Serino M, Tilg H, Watson A, Wells JM. Intestinal permeability--a new target for disease prevention and therapy. BMC Gastroenterol. 2014; 14:189. [PMID: 25407511 / DOI: 10.1186/s12876-014-0189-7]

----------------------------------------------------------------------------------

Ferolla SM, Silva LC, Ferrari Mde L, da Cunha AS, Martins Fdos S, Couto CA, Ferrari TC. Dietary approach in the treatment of nonalcoholic fatty liver disease. World J Hepatol. 2015; 7: 2522–2534. [PMID: 26523205 / DOI: 10.4254/wjh.v7.i24.2522]

------------------------------------------------------------------------------------

Abenavoli L. Non-alcoholic fatty liver disease and beneficial effects of dietary supplements. World J Hepatol. 2015; 7: 1723¬–1724. [PMID: 26140093 / DOI: 10.4254/wjh.v7.i12.1723]

-----------------------------------------------------------------------------------

Rojas-Feria M, Castro M, Suárez E, Ampuero J, Romero-Gómez M. Hepatobiliary manifestations in inflammatory bowel disease: The gut, the drugs and the liver. World J Gastroenterol. 2013; 19: 7327-7340. [PMID: 24259964 / DOI: 10.3748/wjg.v19.i42.7327]

------------------------------------------------------------------------------------

Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology. 2006; 130:1480-91. [PMID: 16678561 / DOI: 10.1053/j.gastro.2005.11.061]

------------------------------------------------------------------------------------

Jamali R, Pourshams A, Amini S, Deyhim MR, Rezvan H, Malekzadeh R. The upper normal limit of serum alanine aminotransferase in Golestan Province, northeast Iran. Arch Iran Med. 2008; 11:602-607. [PMID: 18976029]

------------------------------------------------------------------------------------

Jamali R, Arj A, Razavizade M, Aarabi MH. Prediction of Nonalcoholic Fatty Liver Disease Via a Novel Panel of Serum Adipokines. Medicine (Baltimore). 2016; 95: e2630. [PMID: 26844476 / DOI: 10.1097/MD.0000000000002630.]

------------------------------------------------------------------------------------

Jamali R, Mofid A, Vahedi H, Farzaneh R, Dowlatshahi S. The effect of helicobacter pylori eradication on liver fat content in subjects with non-alcoholic Fatty liver disease: a randomized open-label clinical trial. Hepat Mon. 2013; 13:e14679. [PMID: 24358044 / DOI: 10.5812/hepatmon.14679]

-----------------------------------------------------------------------------------

Kotronen A, Peltonen M, Hakkarainen A, Sevastianova K, Bergholm R, Johansson LM, et al. Prediction of non-alcoholic fatty liver disease and liver fat using metabolic and genetic factors. Gastroenterology. 2009; 137: 865-72. [PMID:19524579 / DOI:10.1053/j.gastro.2009.06.005]

------------------------------------------------------------------------------------

Dolatshahi S, Pishgar E, Jamali R. Does serum 25 hydroxy vitamin D level predict disease activity in ulcerative colitis patients? Acta Clin Belg. 2016; Acta Clin Belg. 2016; 71: 46-50. [PMID: 27075790 / DOI: 10.1080/17843286.2015.1110895.]

-----------------------------------------------------------------------------------

Razavizade M, Jamali R, Arj A, Matini SM, Moraveji A, Taherkhani E. The effect of pioglitazone and metformin on liver function tests, insulin resistance, and liver fat content in nonalcoholic Fatty liver disease: a randomized double blinded clinical trial. Hepat Mon. 2013; 13:e9270. [PMID: 23930133 / DOI: 10.5812/hepatmon.9270.]

---------------------------------------------------------------------------------

Razavizade M, Jamali R, Arj A, Talari H. Serum parameters predict the severity of ultrasonographic findings in non-alcoholic fatty liver disease. Hepatobiliary Pancreat Dis Int. 2012; 11:513-520. [PMID: 23060397 / DOI:10.1016/S1499-3872(12)60216-1]

------------------------------------------------------------------------------------

Bargiggia S, Maconi G, Elli M, Molteni P, Ardizzone S, Parente F, Todaro I, Greco S, Manzionna G, Bianchi Porro G. Sonographic prevalence of liver steatosis and biliary tract stones in patients with inflammatory bowel disease: study of 511 subjects at a single center. J Clin Gastroenterol. 2003; 36: 417–420. [PMID: 12702985]

-----------------------------------------------------------------------------------

Dordal E, Glagov S, Kirsner JB. Hepatic lesions in chronic inflammatory bowel disease. I. Clinical correlations with liver biopsy diagnoses in 103 patients. Gastroenterology. 1967; 52:239– 253. [PMID: 6020388]

-----------------------------------------------------------------------------------

Eade MN. Liver disease in ulcerative colitis. I. Analysis of operative liver biopsy in 138 consecutive patients having colectomy. Ann Intern Med. 1970; 72: 475–487. [PMID: 5437630]

----------------------------------------------------------------------------------

Mattila J, Aitola P, Matikainen M. Liver lesions found at colectomy in ulcerative colitis: correlation between histological findings and biochemical parameters. J Clin Pathol. 1994. 47: 1019–1021. [PMID: 7829676]

Yamamoto-Furusho JK, Sánchez-Osorio M, Uribe M. Prevalence and factors associated with the presence of abnormal function liver tests in patients with ulcerative colitis. Ann Hepatol. 2010; 9: 397-401. [PMID: 21057158]

Lee SS, Park SH, Kim HJ, Kim SY, Kim MY, Kim DY, Suh DJ, Kim KM, Bae MH, Lee JY, Lee SG, Yu ES. Non-invasive assessment of hepatic steatosis: prospective comparison of the accuracy of imaging examinations. J Hepatol. 2010; 52: 579-85. [PMID: 20185194 / DOI: 10.1016/j.jhep.2010.01.008.]

Riegler G, D'Incà R, Sturniolo GC, Corrao G, Del Vecchio Blanco C, Di Leo V, Carratù R, Ingrosso M, Pelli MA, Morini S, Valpiani D, Cantarini D, Usai P, Papi C, Caprilli R. Hepatobiliary alterations in patients with inflammatory bowel disease: a multicenter study. Scand J Gastroenterol. 1998; 33:93–8. [PMID: 9489915]

Files
IssueVol 55, No 5 (2017) QRcode
SectionOriginal Article(s)
Keywords
Ulcerative colitis Non-alcoholic fatty liver disease Severity Ultrasound Fatty liver

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Jamali R, Biglari M, Seyyed Hosseini SV, Shakouri Rad A, Kosari F. The Correlation Between Liver Fat Content and Ulcerative Colitis Disease Severity. Acta Med Iran. 2017;55(5):333-339.