The use of steroids was not associated with non-alcoholic fatty liver disease (NAFLD) in patients with inflammatory bowel disease (IBD) according to a recent meta-analysis published in the Journal of Clinical Gastroenterology. As such, the study’s authors proposed that steroid use may not need to be avoided in patients with IBD to reduce the risk of NAFLD.

The researchers identified 12 observational studies comprising 3,497 patients with ulcerative colitis or Crohn’s disease. They used odds ratios (ORs), forest plots, and random effects models to define links between steroids and NAFLD development. Publications’ biases and quality were assessed with funnel plots, Egger’s test, the modified Newcastle-Ottawa scale, and Agency for Healthcare Research and Quality tools.

The pooled OR for NAFLD in steroid users vs non-users was 0.87 (95% CI, 0.72-1.04), according to the researchers. These findings were consistent within subgroups stratified by study quality. Additionally, the investigators reported no significant heterogeneity (I2=0.00%; P=.13) and no publication bias (P=.24) among the included articles, supporting the validity of their analysis.

The authors concluded that steroid use was not associated with development of NAFLD in patients with IBD, indicating some other mechanism driving the population’s increased risk. However, they did note that further studies exploring steroid exposure and confounders were warranted.

Reference: Trivedi HD, Lopes EW, Glissen Brown J, et al. Steroid use and risk of nonalcoholic fatty liver disease in patients with inflammatory bowel disease: systematic review and meta-analysis. J Clin Gastroenterol. 2022; 10.1097/MCG.0000000000001727. doi:10.1097/MCG.0000000000001727