Impact of metabolic syndrome on the hospitalization rate of Crohn's disease patients seen at a tertiary care center: a retrospective cohort study.

BACKGROUND/AIMS: Recent studies suggest that markers of mesenteric inflammation, such as increased adipose tissue, may be associated with poor outcomes in Crohn's disease (CD). This study's hypothesis is that CD patients with metabolic syndrome (MetS) have more CD-related hospitalizations than CD patients without MetS. METHODS: We conducted a retrospective cohort study of CD patients seen from 2000 to 2012 at our tertiary care center. We analyzed crude and age-, sex- and duration of CD-adjusted incidence rate ratio (IRR) of CD-related hospitalization of those with MetS versus those without MetS. We also investigated possible associations between individual component conditions of MetS and rate of CD-related hospitalization. RESULTS: A total of 868 CD patients were included. There were 37 (4%) patients with MetS at initial observation. After multi-variable adjustment, patients with MetS had a CD-related hospitalization rate twice that of those who did not have MetS. High triglycerides (TG), low high density lipoprotein (HDL) cholesterol and diabetes mellitus (DM) were associated with increased risk of CD-related hospitalization. CONCLUSIONS: CD patients with MetS have a higher rate of CD-related hospitalization compared to those without MetS. Hypertriglyceridemia, low HDL cholesterol and DM may be good markers of local and systemic inflammation as seen in CD.

Autoimmune hepatitis: a review.

Autoimmune Hepatitis (AIH) is a periportal hepatitis with increased immunoglobulins and auto antibodies, which primarily responds to immunosuppression. It affects women 3.6 times more commonly than men. It is postulated that an environmental agent, either a drug or a virus or another agent seems to trigger a T-cell mediated cascade directed against liver antigens in genetically predisposed individuals to cause AIH. Diagnosis requires exclusion of other causes of liver disease. The diagnostic criteria have been defined in a simplified scoring system introduced by the International Autoimmune Hepatitis Group (IAIHG) in 2008. Current treatment of AIH is based on guidelines published by the American Association for the Study of Liver Diseases (AASLD) in 2002 and comprises of corticosteroids with azathioprine. Steroids tend to carry a high complication risk profile; hence several newer immunomodulators and biologics are in different stages of trials to assess their efficacy and safety.