Table 1.
Pooled prevalence of non-alcoholic faatty liver disease (NAFLD) in patients with inflammatory bowel disease (IBD) according to sex, World Health Origanisation (WHO) regions, publication year, diagnostic method of NAFLD, and disease activity, localization and behavior
| Disease type | No. of studies | No. of IBD patients | Pooled prevalence of NAFLD, % (95% CI) | P-value for subgroups | I 2 | P-value for χ2 | |
|---|---|---|---|---|---|---|---|
| IBD | Overall | 44 | 14,947 | 30.7 (26.5–34.9) | 97.7% | <0.001 | |
| Sex | |||||||
| Men | 15 | 2,836 | 33.2 (25.5–40.9) | 0.040 | 96.0% | <0.001 | |
| Women | 15 | 2,698 | 27.0 (20.5–33.4) | 93.3% | <0.001 | ||
| WHO Region | |||||||
| Region of the Americas | 18 | 7,316 | 28.2 (22.2–34.3) | <0.001 | 98.0% | <0.001 | |
| South-East Asian Region | 2 | 228 | 29.7 (6.2–53.3) | 93.8% | <0.001 | ||
| European Region | 19 | 5,457 | 36.9 (31.2–42.6) | 95.1% | <0.001 | ||
| Eastern Mediterranean Region | 1 | 913 | 11.8 (9.7–13.9) | NA | NA | ||
| Western Pacific Region | 4 | 1,033 | 17.2 (10.3–24.1) | 88.7% | <0.001 | ||
| Publication year | |||||||
| 2003–2010 | 4 | 739 | 25.2 (10.2–40.2) | 0.258 | 94.4% | <0.001 | |
| 2011–2016 | 9 | 4,232 | 25.9 (18.8–33.0) | 97.4% | <0.001 | ||
| 2017–2021 | 31 | 9,976 | 32.8 (27.4–38.2) | 97.8% | <0.001 | ||
| Diagnostic method of NAFLD | |||||||
| Imaging | 35 | 11,239 | 30.5 (25.8–35.2) | <0.001 | 97.7% | <0.001 | |
| Histopathology | 4 | 1,025 | 36.2 (27.6–44.8) | 77.0% | 0.005 | ||
| HSI | 2 | 571 | 34.8 (30.9–38.7) | 0.0% | 0.494 | ||
| Imaging or histopathology | 1 | 1,672 | 12.4 (10.8–14.0) | NA | NA | ||
| Imaging or HSI | 2 | 440 | 30.8 (10.9–50.6) | 95.5% | <0.001 | ||
| Disease activity | |||||||
| Active | 6 | 690 | 34.5 (18.8–50.2) | 0.971 | 95.8% | <0.001 | |
| Remission | 6 | 1,276 | 34.2 (27.2–41.2) | 85.8% | <0.001 | ||
| CD | Overall | 25 | 5,223 | 34.4 (28.0–40.8) | 96.9% | <0.001 | |
| Sex | |||||||
| Men | 5 | 683 | 33.2 (16.5–50.0) | 0.736 | 96.5% | <0.001 | |
| Women | 5 | 470 | 29.7 (17.3–42.0) | 88.6% | <0.001 | ||
| WHO Region | |||||||
| Region of the Americas | 8 | 2,380 | 36.7 (23.6–49.8) | <0.001 | 98.1% | <0.001 | |
| South-East Asian Region | 1 | 100 | 42.0 (32.3–51.7) | NA | NA | ||
| European Region | 11 | 1,610 | 40.3 (34.4–46.2) | 82.2% | <0.001 | ||
| Eastern Mediterranean Region | 1 | 383 | 11.8 (8.5–15) | NA | NA | ||
| Western Pacific Region | 4 | 750 | 16.0 (7.3–24.7) | 90.6% | <0.001 | ||
| Publication year | |||||||
| 2003–2010 | 1 | 311 | 39.6 (34.1–45.0) | 0.420 | NA | NA | |
| 2011–2016 | 3 | 491 | 35.7 (29.5–42.0) | 52.6% | 0.121 | ||
| 2017–2021 | 21 | 4,421 | 33.9 (26.9–41.0) | 97.1% | <0.001 | ||
| Diagnostic method of NAFLD | |||||||
| Imaging | 21 | 3,903 | 34.1 (26.7–41.6) | <0.001 | 97.0% | <0.001 | |
| Histopathology | 1 | 39 | 61.5 (46.3–76.8) | NA | NA | ||
| HSI | 2 | 384 | 37.0 (32.2–41.8) | 0.0% | 0.872 | ||
| Imaging or histopathology | 1 | 897 | 14.6 (12.3–16.92) | NA | NA | ||
| Disease activity | |||||||
| Active | 5 | 341 | 40.0 (12.3–67.7) | 0.651 | 96.4% | <0.001 | |
| Remission | 5 | 856 | 33.4 (26.1–40.6) | 80.2% | 0.001 | ||
| Disease location | |||||||
| Ileal | 5 | 361 | 28.8 (19.1–38.5) | 0.527 | 76.4% | 0.002 | |
| Colonic | 5 | 236 | 18.4 (5.6–31.2) | 84.3% | <0.001 | ||
| Ileocolonic | 5 | 655 | 23.0 (11.0–35.0) | 93.2% | <0.001 | ||
| Upper gastrointestinal | 3 | 39 | 23.7 (10.2–37.2) | 0.0% | 0.983 | ||
| Disease behavior | |||||||
| Non-stricturing, non-penetrating | 4 | 409 | 24.3 (6.4–42.1) | 0.182 | 96.0% | <0.001 | |
| Stricturing | 4 | 267 | 30.0 (20.6–39.4) | 62.0% | 0.048 | ||
| Penetrating | 4 | 211 | 32.0 (15.3–48.6) | 85.5% | <0.001 | ||
| UC | Overall | 22 | 3,101 | 28.2 (22.0–34.3) | 95.1% | <0.001 | |
| Sex | |||||||
| Men | 2 | 120 | 32.9 (0.0–70.1) | 0.031 | 95.8% | <0.001 | |
| Women | 2 | 102 | 20.1 (0.0–52.4) | 95.9% | <0.001 | ||
| WHO Region | |||||||
| Region of the Americas | 7 | 992 | 19.3 (11.5–27.1) | <0.001 | 90.6% | <0.001 | |
| South-East Asian Region | 1 | 128 | 18.0 (11.3–24.6) | NA | NA | ||
| European Region | 10 | 1,168 | 40.0 (31.5–47.7) | 88.4% | <0.001 | ||
| Eastern Mediterranean Region | 1 | 530 | 11.9 (9.1–14.6) | NA | NA | ||
| Western Pacific Region | 3 | 283 | 17.2 (8.8–25.5) | 68.7% | 0.041 | ||
| Publication year | |||||||
| 2003–2010 | 2 | 265 | 25.7 (6.0–45.4) | 0.962 | 92.2% | <0.001 | |
| 2011–2016 | 3 | 353 | 28.1 (22.2–34.1) | 36.5% | 0.207 | ||
| 2017–2021 | 17 | 2,483 | 28.6 (21.4–35.8) | 95.7% | <0.001 | ||
| Diagnostic method of NAFLD | |||||||
| Imaging | 18 | 2,407 | 29.7 (22.3–37.0) | <0.001 | 95.1% | <0.001 | |
| Histopathology | 1 | 54 | 18.5 (8.2–28.9) | NA | NA | ||
| HSI | 2 | 187 | 30.6 (20.7–40.5) | 55.4% | 0.134 | ||
| Imaging or histopathology | 1 | 453 | 8.6 (6.0–11.2) | NA | NA | ||
| Disease activity | |||||||
| Active | 3 | 185 | 35.7 (13.9–57.5) | 0.865 | 87.0% | <0.001 | |
| Remission | 3 | 270 | 33.3 (16.4–50.2) | 89.4% | <0.001 | ||
| Disease extent | |||||||
| Proctitis | 2 | 190 | 21.5 (13.1–30.0) | 0.467 | 50.1% | 0.157 | |
| Left-side | 2 | 143 | 14.9 (4.7–25.2) | 64.3% | 0.094 | ||
| Extensive | 2 | 127 | 25.3 (9.8–40.7) | 76.9% | 0.038 |
CI=confidence interval. HIS=hepatic steatosis index. CD=Crohn’s disease. UC=ulcerative colitis