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Intestinal gas and liver steatosis: a casual association? A prospective multicentre assessment
Author(s) -
Maconi Giovanni,
Furfaro Federica,
Fries Walter,
Dell'Era Alessandra,
Bezzio Cristina,
Costantino Giuseppe,
Giuliano Vittorio,
Alibrandi Angela,
Guzowski Tom,
Bassotti Gabrio
Publication year - 2017
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13198
Subject(s) - steatosis , medicine , gastroenterology , body mass index , univariate analysis , fatty liver , transaminase , abdominal ultrasonography , alanine transaminase , prospective cohort study , pathology , multivariate analysis , ultrasonography , surgery , biology , disease , biochemistry , enzyme
Background & Aims Excessive intestinal gas and liver steatosis are frequent sonographic findings. Both of these appear to be caused by variations of the gut microflora. We assessed the relationship between ultrasonographic detection of intestinal gas and liver steatosis. Methods This study included 204 consecutive patients (99 male; mean age 53.0 ± 15.6 years), who underwent ultrasonography for abdominal complaints or follow‐up of benign lesions. Body mass index, biochemical liver markers, sonographic presence of liver steatosis and/or degree of intestinal gas interfering with the examination were collected. Both sonographic findings were assessed based on standardized criteria. The association between liver steatosis and intestinal gas was evaluated by means of univariate and multivariate analyses. Results Eighty (39.2%) of patients showed moderate to large amounts of gas preventing an accurate evaluation of the liver or pancreas and 90 (44.1%) had liver steatosis. A significant correlation between the degree of intestinal gas and liver steatosis both in obese ( r =.603; P <.001) and in nonobese patients ( r =.555; P <.001) was found. Univariate analysis showed that intestinal gas, body mass index, aspartate transaminase, alanine transaminase, gamma‐ GT , age and sex were predictors of liver steatosis; only intestinal gas ( OR 7.4; 95% CI 3.4–16.1) and body mass index (OR; 1.4, 95% CI 1.2–1.5), however, were independent predictors at multivariate analysis. The presence of excessive gas was also significantly correlated with liver steatosis coupled with elevated ALT ( P = .001). Conclusion This study shows a significant correlation between excessive intestinal gas and liver steatosis. The reasons of this finding and its clinical implications remain to be defined.