Prevalence and etiology of abnormal liver function tests in a tertiary inflammatory bowel disease cohort in the United Arab Emirates: A cross-sectional study

Abstract

Background:
Abnormal liver function tests (LFTs) are common in inflammatory bowel disease (IBD), yet data from the Middle East are lacking. We aimed to determine the prevalence, etiological spectrum, and risk factors for abnormal LFTs in a tertiary IBD cohort in the United Arab Emirates.


Methods:
In this retrospective cohort study with cross-sectional and longitudinal components, all adult IBD patients in a tertiary institutional registry were screened for abnormal LFTs. Etiologies were assigned across predefined categories, and logistic regression identified associated factors.


Results:

Persistent abnormal LFTs (per the operational definition) were identified in 72 of 510 patients (14.1%, 95% CI 11.4–17.4%). The most common etiology was metabolic dysfunction-associated steatotic liver disease (MASLD, 22.2%), followed by infection-related causes (11.1%), drug-induced liver injury (11.1%), and IBD activity-related causes (4.2%). Viral hepatitis screening was performed in ≥86% of cases; autoimmune markers were tested in 36–56%, and FibroScan in 24%. After adjustment for concomitant primary sclerosing cholangitis (PSC-IBD) as a clinically important confounder, cumulative advanced therapy exposure remained associated with abnormal LFTs (adjusted OR 1.20, 95% CI 1.00–1.42,
P
= 0.041); PSC-IBD itself was strongly associated with abnormal LFTs in the model (adjusted OR 8.69, 95% CI 3.11–25.24,
P
< 0.001), as expected. LFTs normalized in 30.0% and improved in 20.0% of patients during follow-up.



Conclusions:
Abnormal LFTs affected one in seven IBD patients in this UAE cohort, with MASLD as the leading cause. These findings suggest potential value in integrating structured liver investigation algorithms into routine IBD care.