Metabolic dysfunction-associated steatotic liver disease prevalence and risk factors in inflammatory bowel disease in tertiary center.

OBJECTIVE: The aim of this study was to evaluate the prevalence and risk factors related to metabolic dysfunction-associated steatotic liver disease in inflammatory bowel disease patients. METHODS: This is a cross-sectional study conducted on adults with inflammatory bowel disease from 2019 to 2021. Metabolic dysfunction-associated steatotic liver disease encompasses patients with steatosis and at least one cardiometabolic risk factor. Patients with alcohol consumption ≥20 g/day, chronic liver diseases, or methotrexate use were excluded. RESULTS: Almost 140 patients were included: 67.1% were female, with a mean age of 49.7±13.7 years, and 63.6% had Crohn's disease. The mean duration of inflammatory bowel disease was 9.7±7.9 years. Metabolic dysfunction-associated steatotic liver disease was observed in 44.3% and advanced liver fibrosis was excluded in 63.5% by Fibrosis-4. Patients with metabolic dysfunction-associated steatotic liver disease were older (p = 0.003) and had a higher number of metabolic syndrome components (2.9±1.1 versus 1.6±1.0; p<0.001), greater abdominal circumference (p<0.001), and body mass index (p<0.001). The only factor related to inflammatory bowel disease associated with metabolic dysfunction-associated steatotic liver disease was disease duration (11.6±9.5 versus 8.3±6.2; p = 0.017). A higher number of metabolic syndrome components and obesity increase by 2.2 times and an altered waist circumference by 2.6 times the occurrence of metabolic dysfunction-associated steatotic liver disease. CONCLUSION: A high prevalence of metabolic dysfunction-associated steatotic liver disease was observed in patients with inflammatory bowel disease, with the main risk factors being associated with metabolic syndrome predicting it, but not with inflammatory bowel disease features and/or its treatment.

Metabolic dysfunction-associated steatotic liver disease prevalence and risk factors in inflammatory bowel disease in tertiary center

SUMMARY OBJECTIVE: The aim of this study was to evaluate the prevalence and risk factors related to metabolic dysfunction-associated steatotic liver disease in inflammatory bowel disease patients. METHODS: This is a cross-sectional study conducted on adults with inflammatory bowel disease from 2019 to 2021. Metabolic dysfunction-associated steatotic liver disease encompasses patients with steatosis and at least one cardiometabolic risk factor. Patients with alcohol consumption ≥20 g/day, chronic liver diseases, or methotrexate use were excluded. RESULTS: Almost 140 patients were included: 67.1% were female, with a mean age of 49.7±13.7 years, and 63.6% had Crohn's disease. The mean duration of inflammatory bowel disease was 9.7±7.9 years. Metabolic dysfunction-associated steatotic liver disease was observed in 44.3% and advanced liver fibrosis was excluded in 63.5% by Fibrosis-4. Patients with metabolic dysfunction-associated steatotic liver disease were older (p = 0.003) and had a higher number of metabolic syndrome components (2.9±1.1 versus 1.6±1.0; p<0.001), greater abdominal circumference (p<0.001), and body mass index (p<0.001). The only factor related to inflammatory bowel disease associated with metabolic dysfunction-associated steatotic liver disease was disease duration (11.6±9.5 versus 8.3±6.2; p = 0.017). A higher number of metabolic syndrome components and obesity increase by 2.2 times and an altered waist circumference by 2.6 times the occurrence of metabolic dysfunction-associated steatotic liver disease. CONCLUSION: A high prevalence of metabolic dysfunction-associated steatotic liver disease was observed in patients with inflammatory bowel disease, with the main risk factors being associated with metabolic syndrome predicting it, but not with inflammatory bowel disease features and/or its treatment.

Fine needle aspiration biopsy for improving the diagnostic accuracy of cut needle biopsy of focal liver lesions.

OBJECTIVE: To determine the value of fine needle aspiration biopsy (FNAB) in comparison to cut needle biopsy (CNB) for the diagnosis of malignancy of focal liver lesions. STUDY DESIGN: A retrospective analysis was conducted on 68 FNAB and 49 CNB procedures performed on 62 patients with focal liver lesions. RESULTS: Cytology permitted a diagnosis of the lesion in 78% of cases. When punctures with insufficient material were excluded (11), the diagnostic accuracy of FNAB was 93%. For the 49 patients who underwent both procedures, FNAB and CNB had the same diagnostic accuracy, 78%, when considered separately and of 88% when considered in combination. Sensitivity, specificity and positive predictive value were similar for the 2 techniques. The negative predictive value was 64% for FNAB and CNB used separately and reached 78% when the 2 techniques were combined. There were no complications during the execution of FNAB and CNB. CONCLUSION: FNAB is an effective and safe method for the diagnosis of focal hepatic lesions, with diagnostic accuracy similar to that of CNB. When the 2 techniques are combined, the accuracy of the diagnosis of malignancy of focal liver lesions increases.

Avaliação da frequência de esteatose hepática detectada ao ultrassom abdominal de pacientes obesos não alcoolistas / Evaluation of the prevalence of liver steatosis detected by ultrasound in the abdomen of non-alcoholic obese patients

Introdução: A doença hepática gordurosa não alcoólica (DHGNA) é uma condição de elevada prevalência, caracterizada por acúmulo de lípides no fígado (esteatose hepática), que pode estar eventualmente associada a desenvolvimento de hepatite crônica e cirrose hepática. Sua frequência em nosso meio é pouco conhecida, sobretudo em determinados grupos de risco, como os obesos. O papel de exames não invasivos, como o ultrassom (US) abdominal, é maldeterminado para o seu diagnóstico e rastreamento. Por outro lado, parece ser de grande interesse, desde que poderia dispensar a realização da biópsia hepática, exame invasivo e associado a complicações, atual padrão ouro para diagnóstico de DHGNA. Objetivo: Avaliar o papel do US no rastreamento da esteatose hepática associada a DHGNA, a frequência de esteatose detectada por US em obesos não alcoolistas e às condições associadas a este achado. Métodos: Trata-se de estudo retrospectivo, com revisão de prontuários de 149 obesos não alcoolistas, que foram submetidos a USo Foram analisadas as características clínicas, labotatoriais e ultrassonográficas deste grupo, sendo que aqueles com esteatose hepática foram comparados àqueles sem esteatose hepática, quanto às suas características. A análise estatística adotou significância estatística quando p < 0,05.Resultados: A frequência de esteatose hepática detectada ao US foi de 10% (15 pacientes). A presença de diabetes melito tipo 2, dislipidemia, obesidade classe III e maior circunferência abdominal se associou a achado de esteatose ultrassonográfica, presumível DHGNA. Conclusão: A frequência de esteatose hepática ultrassonográfica em obesos não alcoolistas foi de 10%. Os fatores associados à sua presença foram diabetes melito do tipo 2, dislipidemia, obesidade classe 111 e maior circunferência abdominal.

Avaliação da qualidade de vida de pacientes com dispepsia não investigada com base no questionário SF-36: um estudo controlado / Quality of life investigation in patients with non-investigated dyspepsia based on the SF-36 questionnaire: a controlled study

Introdução: O termo "dispepsia não investigada" (DNI) diz respeito a um conjunto de sintomas frequentemente atribuídos a desordens do transito digestivo alto, mas que não foram explorados por métodos diagnósticos específicos. Independente de sua natureza funcional ou orgânica, a DNI tem alta prevalência, inclusive no Brasil, constituindo relevante problema de saúde pública. Estima-se que essa condição possa interferir significativamente na qualidade de vida dos indivíduos, a exemplo do que já foi previamente constatado para outras enfermidades. No entanto, esse fato é ainda pouco conhecido, sobretudo em nosso meio. Objetivo: Avaliar a qualidade de vida de adultos com DNI através dos questionário de qualidade de vida Medical Outcome Study Short Form-36 Health Survey (SF-36) comparando-os com controles saudáveis. Métodos: No ano de 2007, foram estudados consecutivamente, pacientes com DNI atendidos em ambulatório de atenção primária à saúde (G1). Para análise comparativa, foram avaliados controles saudáveis pareados por idade e sexo (G2). Empregou-se o questionário de qualidade de vida SF-36 em todos os indivíduos do G1 e G2, com cálculo dos escores médios obtidos nos oito domínios contemplados por essa ferramenta. Na análise estatística adotou-se nível de significância estatística...