title: Liver test abnormalities predict complicated disease behaviour in patients with newly diagnosed Crohn's disease.
abstract: BACKGROUND
  In coeliac disease, the prevalence of liver test abnormalities (LTAs) is higher in patients with more severe mucosal inflammation. In Crohn's disease, prognosis is related to the severity of mucosal inflammation.
  
  
  OBJECTIVE
  The aim of this study was to investigate whether the presence of LTA predicts the occurrence of complicated disease behaviour in newly diagnosed Crohn's disease.
  
  
  METHODS
  A retrospective cohort study was performed in patients newly diagnosed with Crohn's disease between 2002 and 2011. The complicated disease was defined as the occurrence of stricturing and/or perforating disease. LTAs were defined as a value of any of alkaline phosphatase (AP), gamma-glutamyl transpeptidase (GGT), aspartate aminotransferase (AST), or alanine aminotransferase (ALT) over the upper limit of normal.
  
  
  RESULTS
  Three hundred eighty-three patients were included, of whom 34.1% had LTA. LTAs were mostly mild (less than two times the upper limit of normal). During the 5-year follow-up, 33.1% of patients in the group with LTA developed complicated disease behaviour compared to 14.6% in patients without LTA (p < 0.001). The presence of LTA was identified as a risk factor for complicated disease behaviour (HR 2.6, 95% confidence interval (CI) 1.5-4.2, p < 0.0001).
  
  
  CONCLUSIONS
  In newly diagnosed Crohn's disease, the presence of LTA was an independent risk factor for the development of complicated disease behaviour.
authors.affiliation: Department of Gastroenterology-Hepatology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Jessika
authors.initials: J
authors.lastname: Barendregt
authors.affiliation: Department of Gastroenterology-Hepatology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Myrthe
authors.initials: M
authors.lastname: de Jong
authors.affiliation: Department of Gastroenterology-Hepatology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Jeoffrey J
authors.initials: JJ
authors.lastname: Haans
authors.affiliation: Department of Gastroenterology-Hepatology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Bart
authors.initials: B
authors.lastname: van Hoek
authors.affiliation: Department of Gastroenterology-Hepatology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: James
authors.initials: J
authors.lastname: Hardwick
authors.affiliation: Department of Gastroenterology-Hepatology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Roeland
authors.initials: R
authors.lastname: Veenendaal
authors.affiliation: Department of Gastroenterology-Hepatology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Andrea
authors.initials: A
authors.lastname: van der Meulen
authors.affiliation: Department of Gastroenterology-Hepatology, Haaglanden Medical Centre, The Hague, The Netherlands.
authors.forename: Nidhi
authors.initials: N
authors.lastname: Srivastava
authors.affiliation: Department of Gastroenterology-Hepatology, Haga Hospital, The Hague, The Netherlands.
authors.forename: Rogier
authors.initials: R
authors.lastname: Stuyt
authors.affiliation: Department of Gastroenterology-Hepatology, Leiden University Medical Centre, Leiden, The Netherlands. P.W.J.Maljaars@lumc.nl.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Maljaars
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D018450:Disease Progression; D005260:Female; D006760:Hospitalization; D006801:Humans; D008099:Liver / Q000503:physiopathology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D055815:Young Adult
keywords: Complications; Inflammatory bowel disease; Prognosis