Exploring the Overlap of MASLD and IBD: Insights from a Single-Center Experience

Metabolic dysfunction-associated steatotic liver disease (MASLD) is an increasingly prevalent condition worldwide, occurring both independently and, more importantly, as the most common extraintestinal complication of inflammatory bowel disease (IBD). The study primarily investigated MASLD prevalence in Crohn's disease (CD) and ulcerative colitis (UC) to enhance prevention and early detection, especially given the recent approval of the first treatment for this condition. Secondary objectives included identifying risk factors, exploring the uric acid/high-density lipoprotein cholesterol ratio (UHRatio) as a steatosis marker and evaluating correlations between non-invasive fibrosis scores, Fibrosis-4 (FIB-4), AST-to-Platelet Ratio Index (APRI), and histological fibrosis severity. We conducted a prospective study on 58 patients diagnosed with IBD. The type of IBD was not independently associated with liver steatosis or fibrosis. Disease activity correlated significantly with hepatic steatosis in CD patients and with hepatic fibrosis in UC patients. The UHRatio proved useful in assessing steatosis prevalence, whereas FIB-4 and APRI scores did not correlate significantly with fibrosis severity. This study is, to our knowledge, the first to evaluate UHRatio as a potential predictor of MASLD in patients with IBD, expanding on previous findings reported in the general population. Our results suggest that this non-invasive biomarker, previously used to identify MASLD, may improve early prediction and could serve as a useful screening tool for MASLD in IBD patients.