title: Detection of liver injury in IBD using transient elastography.
abstract: BACKGROUND
  Up to 5% of inflammatory bowel disease (IBD) patients are thought to have clinically significant liver disease due to multifactorial causes, however, this figure may be an underestimate due to reliance on abnormal liver tests (LTs) and/or liver biopsies.
  
  
  OBJECTIVE
  Our aim was to evaluate the prevalence of clinically significant liver disease in IBD patients as defined by an increased liver stiffness measurement (LS) ≥8kPa using transient elastography (TE).
  
  
  METHODS
  110 IBD patients, and 55 non-IBD control subjects, had their LS recorded using FibroScan® (EchoSense, Paris, France) by a single blinded operator trained in TE.
  
  
  RESULTS
  71 Crohn's disease and 39 ulcerative colitis subjects were included. All demographic variables were similar between the IBD and control groups apart from a significantly higher proportion of IBD patients who smoked (17.3% vs 3.6%, P=0.013). Seven IBD patients (6.4%) had an LS over 8 kPa and 3 had persistently elevated LS 6 months later. One patient had compensated cirrhosis. No significant differences in overall LS were observed between the IBD and control groups. Increased BMI and age, however, were independently associated with a higher LS in the IBD but not in the control group (P<0.001 and 0.010 respectively).
  
  
  CONCLUSIONS
  Using TE, the prevalence of clinically significant liver disease in IBD patients is low. The association of increased BMI and age with increased LS in IBD suggests fatty liver disease being the prevailing aetiology in these patients.
authors: Centre for Inflammatory Bowel Diseases, Fremantle Hospital, Fremantle, WA, Australia; Department of Gastroenterology, Fremantle Hospital, Fremantle, WA, Australia.
authors: L W Y
authors: LW
authors: Thin
authors: Centre for Inflammatory Bowel Diseases, Fremantle Hospital, Fremantle, WA, Australia; University Department of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, WA, Australia; Department of Gastroenterology, Fremantle Hospital, Fremantle, WA, Australia. Electronic address: ian.lawrance@uwa.edu.au.
authors: I C
authors: IC
authors: Lawrance
authors: Centre for Population Health Research, Curtin University, Bentley, WA, Australia.
authors: K
authors: K
authors: Spilsbury
authors: Department of Gastroenterology, Fremantle Hospital, Fremantle, WA, Australia.
authors: J
authors: J
authors: Kava
authors: Department of Gastroenterology, Fremantle Hospital, Fremantle, WA, Australia; Curtin Health Innovation Research Institute, Curtin University, Bentley, WA, Australia; Institute for Immunology & Infectious Diseases, Murdoch University, Murdoch, WA, Australia.
authors: J K
authors: JK
authors: Olynyk
mesh_terms: D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D003093:Colitis, Ulcerative / Q000150:complications* / Q000188:drug therapy; D003424:Crohn Disease / Q000150:complications* / Q000188:drug therapy; D003430:Cross-Sectional Studies; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D014409:Tumor Necrosis Factor-alpha
keywords: IBD; Liver stiffness; NAFLD; Transient elastography