P134 Are hepatic steatosis predictive scores still useful to predict metabolic associated fatty liver disease (MAFLD) in Crohn’s disease patients?

Capela, T.(1);Macedo Silva, V.(1);Freitas, M.(1);Cúrdia Gonçalves, T.(1);Magalhães, J.(1);

(1)Hospital da Senhora da Oliveira, Gastroenterology Department, Guimarães, Portugal;


Crohn’s disease (CD) patients have a higher risk of nonalcoholic fatty liver disease (NAFLD) compared with the general population. There are many NAFLD predictive scores, including Hepatic Steatosis Index (HSI), Fatty Liver Index (FLI) and the Clinical Prediction Tool for NAFLD in Crohn’s Disease (CPN-CD), a recently validated score specifically developed for CD patients. However, it is not known whether these scores are useful in predicting metabolic associated fatty liver disease (MAFLD) in CD patients.
Our aim was analyze and compare the performances of CPN-CD, Hepatic Steatosis Index (HSI) and Fatty Liver Index (FLI) in identifying CD patients with MAFLD.


Retrospective cohort study which consecutively included all adult CD patients submitted to transient elastography (TE) from January to December 2020. Patients’ demographic, clinical and biochemical data were recorded. MAFLD criteria were assessed and hepatic steatosis (HS) was defined by a controlled attenuation parameter (CAP) >248 dB/m using TE. CPN-CD, HSI, and FLI were calculated, their accuracy for the prediction of MAFLD was evaluated through a receiver-operating characteristic (ROC) curve and their areas under the ROC curve (AUROC) were compared.


Of 103 CD patients, 56 (54.4%) were female with a mean age of 38.2±11.5 years. Body mass index >25, type 2 diabetes mellitus, dyslipidemia and arterial hypertension were present in 53 (51.5%), 4 (3.9%), 27 (26.2%) and 9 patients (8.7%), respectively. HS was identified in 50 patients (48.5%), of which 44 (88%) fulfilled MAFLD criteria. Median HSI was 38.9 (IQR 7.2) and mean FLI and CPN-CD were 36.7±27.7 and -0.5±1.5, respectively. FLI (AUROC, 0.919; 95% confidence interval, 95% IC, 0.866–0.972), HSI (AUROC, 0.850; 95% CI, 0.775–0.925) and CPN-CD (AUROC, 0.809; 95% CI, 0.722–0.896) had excellent discrimination in predicting MAFLD. FLI performance was significantly higher than CPN-CD (P=0.01) but not significantly different from HSI (P=0.06). Additionality, HSI performance was not significantly different from CPN-CD (P=0.81).


The FLI, HSI and CPN-CD scores can accurately identify MAFLD in CD patients, allowing the selection of those in whom hepatic steatosis and metabolic risk factors assessment may be particularly beneficial.