A259 METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE IS ASSOCIATED WITH MULTI-ORGAN COMORBIDITIES AND FIBROSIS PROGRESSION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE (IBD)
Bibliographic record
Abstract
Abstract Background Patients with IBD are at risk for metabolic dysfunction-associated steatotic liver disease (MASLD) due to chronic inflammation, hepatotoxic drugs, alteration of gut microbiota. MASLD, formerly known as non-alcoholic fatty liver disease, provides a positive rather than negative diagnosis, appropriately assigns a metabolic basis for hepatic steatosis (HS), avoids any potentially stigmatizing term, and excludes alcohol abuse. MASLD carries higher risk of both liver fibrosis progression and extra-hepatic involvement, including cardiovascular disease , extra-hepatic cancer, hypothyroidism, chronic kidney disease (CKD). Data on the effect of MASLD on fibrosis progression and multi-organ co-morbidities are lacking in this population. Aims We aimed to determine if MASLD and liver fibrosis carry a higher risk of extra-hepatic co-morbidities in IBD. Methods We prospectively included consecutive IBD patients who underwent liver stiffness measurement (LSM) with controlled attenuation parameter (CAP) by Fibroscan at a single centre. MASLD was defined as any grade HS without alcohol abuse and viral hepatitis. HS progression was defined as any grade HS (CAPampersand:003E270 dB/m), or transition to severe HS (CAPampersand:003E330 dB/m) with CAPampersand:003E270 but ampersand:003C330 dB/m at baseline. Fibrosis progression was defined as significant liver fibrosis (LSM≥8 kPa), or transition to cirrhosis (LSM≥13 kPa) with LSMampersand:003E8 but ampersand:003C13 kPa at baseline. We estimated incidence rates of HS and fibrosis progression by dividing participants with the outcome by number of person-years (PY) of follow-up. Covariate adjustments for HS progression were evaluated by multivariable Cox regression models and predictors of extra-hepatic conditions by multivariable logistic regression analysis. Results 430 patients were included with mean age 43 years, BMI 25 Kg/m2, IBD duration 14 years, CRP 5.2, ALT 22; females 45%, ulcerative colitis (UC) 31.8%, T2DM 4.7%. Patients with MASLD had higher proportion of CV events (12% vs. 6%), CKD (8% vs. 3%) and hypothyroidism (12% vs. 6%) vs. those without. After adjusting for age, male sex and Crohn’s IBD subtype, MASLD remained an independent predictor of extra-hepatic comorbidities (aOR 1.79, 95% CI 1.15–2.78; p=0.01) with T2DM (aOR 3.53, 95% CI 1.68-7.42; p=0.001). Patients were followed for 26 months (SD 16.4). Rate of HS progression was 16.2 per 100 PY (95% CI, 11.5-22.8) and liver fibrosis progression was 6.12 per 100 PY (95% CI 3.48-10.44). In multivariable analysis, after adjusting for IBD duration and BMI,UC was associated with faster progression of HS (aHR 2.21, 95% CI 1.02-4.91). Conclusions MASLD is associated with extra-hepatic diseases in patients with IBD and can progress to liver fibrosis and cirrhosis. Figure 1. Evolution of NAFLD and associated liver fibrosis in patients with IBD. Funding Agencies CIHR
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".