Table 5.

Studies Assessing the Relationship between NAFLD and Clostridium difficile

Authors	Year	Study design	Sample size	NAFLD diagnosis	Clostridium difficile diagnosis	Significant findings
Papić et al. [113]	2020	Retrospective cohort; single-center	314 patients	Ultrasound	Screening GDH test confirmed with toxin A/B PCR	-OR 3.27 (P=0.04) - association of NAFLD with C difficile infection. Appears to be independent of other components of metabolic syndrome, such as obesity and diabetes mellitus
Nseir et al.	2020	Retrospective cross-sectional; single-center	115 patients	Ultrasound or abdominal CT	Positive stool test for CD Toxin A/B by enzyme immunoassay or PCR for CD	-OR 1.51 (P=0.05) - association of NAFLD with C difficile infection.
						-Majority of patients with NAFLD (63%) had a fibrosis score of more than two points. Consequently, it seems that NAFLD patients with liver fibrosis are at more risk for acquiring CDI
Šamadan et al.	2021	Retrospective cohort; single-center	329 patients	Ultrasound	Screening GDH test confirmed with toxin A/B PCR	-OR 1.81 (P=0.005) - association of NAFLD with recurrent C difficile infection.
						-DM and obesity were not associated with rCDI in this study
						-Statin use was associated with lower rCDI in patients both with and without NAFLD

NAFLD, nonalcoholic fatty liver disease; C. difficile and CD, Clostridium difficile; rCDI, recurrent C difficile infection; GDH, glumatate dehydrogenase; CT, computerized tomography; OR, odds ratio; PCR, polymerase chain reaction.