Background and Aim: Recently, sarcopenia has been proposed as an additional risk factor of nonalcoholic fatty liver disease (NAFLD), and there have been no studies in patients with inflammatory bowel disease (IBD). We aimed to analyze the clinical associations between sarcopenia and NAFLD in IBD patients. Methods: From January 2004 to December 2017, a total of 488 IBD patients, with CT results, were classified according to the presence of NAFLD. Sarcopenia was assessed based on the muscle volume calculated by the total psoas muscle area in the third lumbar region divided by the square of the patient’s height (m2). Results: Among the 443 included patients, NAFLD was diagnosed in 49 patients (11.1%). Sarcopenia was noted in 34.9%; it was more common in the NAFLD group (51.0 vs. 33.0%; p = 0.019). In multivariate analysis, metabolic syndrome (odds ratio [OR], 8.63), hyperuricemia (OR, 4.66), small bowel resection (OR, 3.45), and sarcopenia (OR, 2.99) were significant risk factors of NAFLD in IBD patients. In addition, sarcopenia was an independent risk factor after adjustment for age, sex, and other metabolic factors (OR, 2.26). Conclusions: The prevalence of nonalcoholic fatty liver in IBD patients was 11.1%, and sarcopenia was an independent risk factor.

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