Cardiovascular Risk in Patients with NAFLD and Inflammatory Bowel Diseases

NAFLD's prevalence in IBD patients raises concerns for cardiovascular risk. The study found doubled atherosclerotic cardiovascular disease risk in IBD patients with NAFLD. Transient elastography may predict cardiovascular risk in IBD patients. Targeted risk assessments are crucial for IBD patients with NAFLD.
PUBLISHED IN: Crohns Colitis 360 2023


Metabolic syndrome and its associated conditions (obesity, insulin resistance, and dyslipidemia) are well-characterised risk factors for non-alcoholic fatty liver disease (NAFLD). However, recent studies have noted NAFLD’s increased prevalence in patients with inflammatory bowel diseases (IBD). This newly observed relationship may stem from the chronic inflammation, gut dysbiosis, or long-term polypharmacy observed in individuals with IBD.

Moreover, NAFLD is a multisystem disease with well-known cardiovascular manifestations. Indeed, NAFLD is independently associated with higher risks of cardiovascular disease (CVD) and its related events. In this vein, it follows that the presence of NAFLD may contribute to higher CVD risks in patients with IBD.

The aim of this study was to investigate the impact of NAFLD on atherosclerotic cardiovascular disease (ASCVD) risk in patients with IBD.

Key learnings:

The risk of intermediate-high ASCVD was found to be more than doubled in IBD patients with NAFLD (41.9%) compared to those without (18.1%), despite their relatively young age. This association was especially relevant in patients with longer IBD durations and with ulcerative colitis. As such, NAFLD diagnosed using transient elastography with controlled attenuation parameter may be a valuable tool for predicting cardiovascular risk in IBD patients.

Moreover, targeting cardiovascular risk assessments to patients with IBD and NAFLD, especially in the case of long IBD durations and ulcerative colitis, may be warranted.

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S Duarte, BSc

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