85 Association of Non-Alcoholic Fatty Liver Disease With Body Composition in Patients With Inflammatory Bowel Disease: A Cross-Sectional Study

Background: Inflammatory bowel disease (IBD) and non-alcoholic fatty liver disease (NAFLD) share chronic inflammatory and metabolic features. Understanding their interaction is essential to assess nutritional and metabolic risks. Aim: To evaluate the association between nutritional status, body composition, and NAFLD in IBD patients. Methods: Cross-sectional study including 127 patients (58 Crohn’s disease, 69 ulcerative colitis). Clinical data, metabolic syndrome, nutritional assessment (BMI, anthropometry, bioimpedance), and biochemical parameters were analyzed. NAFLD was diagnosed by liver ultrasound, and patients were categorized into IBD+NAFLD and IBD-only groups. Results: Mean age was 45.6 years, with predominance of females and physical inactivity. NAFLD was identified in 58 patients (45.7%). The IBD+NAFLD group showed higher BMI, fat mass, and waist measures, with increased prevalence of hypertension (P = 0.0446) and dyslipidemia (P = 0.0377). Despite overweight by BMI, most were classified as eutrophic by anthropometry. Moreover, 86.2% met MAFLD criteria. Biochemical analysis revealed higher hematocrit (P = 0.0023), liver enzymes (AST P = 0.0141; ALT P < 0.0001), fasting glucose (P = 0.0107), HbA1c (P = 0.0146), fasting insulin (P = 0.0003), and triglycerides (P = 0.0001), with lower HDL (P = 0.0101) in IBD+NAFLD patients. Conclusions: NAFLD was significantly associated with altered body composition and metabolic impairment in IBD patients. Notably, individuals considered eutrophic by anthropometry also presented liver steatosis, suggesting that traditional nutritional markers may underestimate risk. Comprehensive metabolic and nutritional evaluation should be integrated into IBD management to enable early detection and intervention. Keywords: non-alcoholic fatty liver disease; metabolic syndrome; inflammatory bowel disease; body composition; nutritional assessment.