Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Mar 14;25(6):3278.
doi: 10.3390/ijms25063278.

Inflammatory Bowel Diseases and Non-Alcoholic Fatty Liver Disease: Piecing a Complex Puzzle Together

Rossella Maresca  1 , Irene Mignini  1 , Simone Varca  1 , Valentin Calvez  1 , Fabrizio Termite  1 , Giorgio Esposto  1 , Lucrezia Laterza  1 , Franco Scaldaferri  1 , Maria Elena Ainora  1 , Antonio Gasbarrini  1 , Maria Assunta Zocco  1
Affiliations
Review

Inflammatory Bowel Diseases and Non-Alcoholic Fatty Liver Disease: Piecing a Complex Puzzle Together

Rossella Maresca et al. Int J Mol Sci. .

Abstract

Inflammatory bowel diseases (IBD), comprising Crohn's disease and ulcerative colitis, are systemic and multifaceted disorders which affect other organs in addition to the gastrointestinal tract in up to 50% of cases. Extraintestinal manifestations may present before or after IBD diagnosis and negatively impact the intestinal disease course and patients' quality of life, often requiring additional diagnostic evaluations or specific treatments. Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. Current evidence shows an increased prevalence of NAFLD (and its more advanced stages, such as liver fibrosis and steatohepatitis) in IBD patients compared to the general population. Many different IBD-specific etiopathogenetic mechanisms have been hypothesized, including chronic inflammation, malabsorption, previous surgical interventions, changes in fecal microbiota, and drugs. However, the pathophysiological link between these two diseases is still poorly understood. In this review, we aim to provide a comprehensive overview of the potential mechanisms which have been investigated so far and highlight open issues still to be addressed for future studies.

Keywords: Crohn’s disease; inflammatory bowel diseases; liver steatosis; ulcerative colitis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
IBD-specific risk factors for liver steatosis. Steatotic liver disease in IBD patients results from a series of factors that are not yet fully elucidated. Drugs, gut microbiota, parenteral nutrition, disease activity, and duration, as well as surgical resections, may yield an effect on liver disease, but many questions about liver steatosis pathogenesis in this subset of patients are still unanswered.
Figure 2
Figure 2
Intestinal surgery impact on liver steatosis. Enterocytes and enteroendocrine cells are deeply involved in regulating bile acids, glucose, and lipid metabolism. Surgical resection of intestinal tracts proved to alter such metabolic functions, finally ending in liver steatosis (central arrow). Further molecular details are provided in the main text.
See this image and copyright information in PMC

References

    1. Algaba A., Guerra I., Ricart E., Iglesias E., Mañosa M., Gisbert J.P., Guardiola J., Mínguez M., Castro B., de Francisco R., et al. Extraintestinal Manifestations in Patients with Inflammatory Bowel Disease: Study Based on the ENEIDA Registry. Dig. Dis. Sci. 2020;66:2014–2023. doi: 10.1007/s10620-020-06424-x. - DOI - PubMed
    1. Harbord M., Annese V., Vavricka S.R., Allez M., Acosta M.B.-D., Boberg K.M., Burisch J., De Vos M., De Vries A.-M., Dick A.D., et al. The First European Evidence-based Consensus on Extra-intestinal Manifestations in Inflammatory Bowel Disease. J. Crohns Colitis. 2015;10:239–254. doi: 10.1093/ecco-jcc/jjv213. - DOI - PMC - PubMed
    1. Vavricka S.R., Rogler G., Gantenbein C., Spoerri M., Vavricka M.P., Navarini A.A., French L.E., Safroneeva E., Fournier N., Straumann A., et al. Chronological Order of Appearance of Extraintestinal Manifestations Relative to the Time of IBD Diagnosis in the Swiss Inflammatory Bowel Disease Cohort. Inflamm. Bowel Dis. 2015;21:1794–1800. doi: 10.1097/MIB.0000000000000429. - DOI - PubMed
    1. Hedin C.R.H., Vavricka S.R., Stagg A.J., Schoepfer A., Raine T., Puig L., Pleyer U., Navarini A., van der Meulen-de Jong A.E., Maul J., et al. The pathogenesis of extraintestinal manifestations: Implications for IBD research, diagnosis, and therapy. J. Crohns Colitis. 2019;13:541–554. doi: 10.1093/ecco-jcc/jjy191. - DOI - PubMed
    1. Gizard E., Ford A.C., Bronowicki J.-P., Peyrin-Biroulet L. Systematic review: The epidemiology of the hepatobiliary manifestations in patients with inflammatory bowel disease. Aliment. Pharmacol. Ther. 2014;40:3–15. doi: 10.1111/apt.12794. - DOI - PubMed

MeSH terms