Risk Factors In Ulcerative Colitis Accompanied With Non-alcoholic Fatty Liver Disease

ObjectiveTo explore the risk factors affecting NAFLD in patients with UC,and to analyze its possible pathogenesis,and provide a theoretical basis for its early intervention andtreatment.Method1.A total of 319 patients with UC who were hospitalized for the first time from2012.09.01 to 2018.12.01 were included.The gender,age,body mass index(BMI)and history of smoking were recorded.CRP,ESR,ALT,AST,ALT/AST ratio,GGT,LDH,ALP,LDL-C,creatinine,uric acid,total cholesterol,triglycerides,total protein,albumin,globulin,white blood cell count,neutrophils count,lymphocyte count,hemoglobin,platelet count from venous blood were collected.Liver CT,ultrasound imaging findings and other past history(hypertension,coronary heart disease,diabetes and metabolicsyndrome)were noted.2.All patients were divided into NAFLD group and non-NAFLD group according to whether combined with NAFLD.Student t-tests or the non-parametric Wilcoxon rank sum tests were used for continuous factors.Pearson chi-square tests or the non-parametric Wilcoxon rank sum tests were used for categorical variables.Gender,age,BMI,CRP,ESR,ALT,AST,ALT/AST ratio,GGT,LDH,ALP,LDL-C,creatinine,uric acid,total cholesterol,triglycerides,total protein,albumin,globulin,white blood cell count,neutrophil count,lymphocyte count,hemoglobin,platelets,smoking history,hypertension,coronary heart disease,diabetes and metabolic syndrome were compared.3.In addition,a binary logistic regression analysis was performed to assess risk factors associated with NAFLD in UC.Result1.Of the 319 patients with UC,the incidence rate of women was higher than that of men.The male-female ratio was 1:1.55.The ages range from18 to 84 years old,each age period(ages 18-43,43-54,54-64,≥64)includes 85 cases(26.64%),83 cases(26.02%),77 cases(24.14%%)and 74 cases(23.20%).The BMI was mostly concentrated between18.5-24kg/m~2(171 cases,53.61%),followed by overweight group(85 cases,26.65%)and underweight group(33 cases,10.34%),obesity group(30 cases,9.40%).41 cases had a history of smoking,male smokers were significantly higher than females(28.8%vs.2.6%),and the male-female ratio was 7.2:1.Of the 319 patients with UC,54 had NAFLD(prevalence was 16.93%).2.Compared with UC alone group,there were significant differences among patients with UC combined NAFLD group in BMI,GGT,ALT,ALT/AST ratio,LDL-C,uric acid,triglycerides,ALP,creatinine,lymphocyte count,PLT,Hb,and hypertension,coronaryheart disease,diabetes,metabolic syndrome(P<0.05),while the differences between other indicators were not statistically significant.3.According to dependent variables of UC combined with NAFLD group and UC alone group,logistic regression analysis showed the difference of BMI(P=0.036,OR=1.113),ALT/AST ratio(P=0.001,OR=4.989),Hb(P=0.004,OR=1.028),metabolic syndrome(P=0.001,OR=6.852)was statistically significant.ConclusionBMI,ALT/AST ratio,uric acid,triglyceride,LDL-C,Hb,and metabolic syndrome all have an effect on the development of NAFLD in UC patients.The occurrence of NAFLD in patients with UC is closely related to BMI,metabolic syndrome,Hb,ALT/AST ratio,indicating that insulin resistance,endothelial dysfunction,and lipid peroxidation may be the main causes of NAFLD.Patients with UC who have obesity,high Hb concentration,high ALT/AST ratio,and metabolic syndrome should pay attention to screening forNAFLD for early detection and early intervention.