{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T20:34:53Z","timestamp":1777494893192,"version":"3.51.4"},"reference-count":55,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T00:00:00Z","timestamp":1729814400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hellenic Group for the Study of IBD","award":["2020EOMIFNEp2"],"award-info":[{"award-number":["2020EOMIFNEp2"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Background: Biologic agents used in patients with inflammatory bowel diseases (IBD) may influence the pathophysiology of coexistent metabolic-dysfunction associated steatotic liver disease (MASLD). This study primarily aimed to evaluate the six-month effect of infliximab or vedolizumab vs. no biologics on presumed hepatic steatosis in patients with IBD. Secondary endpoints were their effect on hepatic fibrosis and parameters related to hepatic metabolism. Methods: This prospective, non-randomized, controlled trial assigned adult bio-na\u00efve patients with IBD into three groups: infliximab, vedolizumab, or controls (receiving no biologic). The baseline was the time of the initiation of biologic agents and the endpoint six months later. Hepatic steatosis was evaluated with transabdominal ultrasonography (Hamaguchi score), whereas controlled attenuation parameter (CAP), fatty liver index (FLI), and hepatic steatosis index (HSI) were used as surrogates. Hepatic fibrosis was evaluated with liver stiffness (LS), fibrosis-4 index (FIB-4), and nonalcoholic fatty liver disease (NAFLD) fibrosis score. Results: Sixty-six patients were assigned to infliximab (n = 26), vedolizumab (n = 14), or control (n = 26); At the endpoint, the Hamaguchi score, CAP, FLI, and HSI were not different between groups. LS was not different between groups; however, FIB-4 was increased within all groups, and NAFLD fibrosis score was increased within infliximab and control groups, without significant biologic \u00d7 time interactions. Conclusions: No positive or adverse effect of infliximab or vedolizumab vs. no biologic agents was shown on presumed hepatic steatosis in patients with IBD, who have not been previously exposed to biologic agents. Although no effect of both biologic agent on LS, a slight but significant increase in FIB-4 and NAFLD fibrosis score warrants further studying.<\/jats:p>","DOI":"10.3390\/ph17111432","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T10:50:08Z","timestamp":1729853408000},"page":"1432","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Effect of Biologic Agents on Steatotic Liver Disease in Patients with Inflammatory Bowel Disease: A Prospective, Open-Label Comparative Trial"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3563-4973","authenticated-orcid":false,"given":"Apostolis","family":"Papaefthymiou","sequence":"first","affiliation":[{"name":"First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"},{"name":"Department of Gastroenterology, University Hospital of Larissa, School of Medicine, University of Thessaly, 41100 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8134-9228","authenticated-orcid":false,"given":"Styliani","family":"Sarrou","sequence":"additional","affiliation":[{"name":"Department of Immunology & Histocompatibility, Faculty of Medicine, University of Thessaly, 41100 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Pateras","sequence":"additional","affiliation":[{"name":"Gastroenterology Private Practice, 41222 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8550-8652","authenticated-orcid":false,"given":"Ilias D.","family":"Vachliotis","sequence":"additional","affiliation":[{"name":"First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"},{"name":"Department of Gastroenterology, 424 General Military Training Hospital, 56429 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3752-1315","authenticated-orcid":false,"given":"Georgios","family":"Agrotis","sequence":"additional","affiliation":[{"name":"Department of Radiology, University General Hospital of Larissa, 41100 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0612-2880","authenticated-orcid":false,"given":"Ioanna-Konstantina","family":"Sgantzou","sequence":"additional","affiliation":[{"name":"Department of Radiology, University General Hospital of Larissa, 41100 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Perifanos","sequence":"additional","affiliation":[{"name":"Research Laboratory of Internal Medicine, Department of Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, 41110 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Kapsoritakis","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospital of Larissa, School of Medicine, University of Thessaly, 41100 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1287-7734","authenticated-orcid":false,"given":"Matthaios","family":"Speletas","sequence":"additional","affiliation":[{"name":"Department of Immunology & Histocompatibility, Faculty of Medicine, University of Thessaly, 41100 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianna","family":"Vlychou","sequence":"additional","affiliation":[{"name":"Department of Radiology, University General Hospital of Larissa, 41100 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7075-8464","authenticated-orcid":false,"given":"George N.","family":"Dalekos","sequence":"additional","affiliation":[{"name":"Research Laboratory of Internal Medicine, Department of Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, 41110 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Spyros","family":"Potamianos","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospital of Larissa, School of Medicine, University of Thessaly, 41100 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonis","family":"Goulas","sequence":"additional","affiliation":[{"name":"First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jannis","family":"Kountouras","sequence":"additional","affiliation":[{"name":"Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9232-4042","authenticated-orcid":false,"given":"Stergios A.","family":"Polyzos","sequence":"additional","affiliation":[{"name":"First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2014","DOI":"10.1007\/s10620-020-06424-x","article-title":"Extraintestinal Manifestations in Patients with Inflammatory Bowel Disease: Study Based on the ENEIDA Registry","volume":"66","author":"Algaba","year":"2021","journal-title":"Dig. Dis. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/apt.12794","article-title":"Systematic Review: The Epidemiology of the Hepatobiliary Manifestations in Patients with Inflammatory Bowel Disease","volume":"40","author":"Gizard","year":"2014","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1111\/liv.13265","article-title":"Hepatic Manifestations of Inflammatory Bowel Diseases","volume":"37","author":"Restellini","year":"2017","journal-title":"Liver Int."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2315","DOI":"10.1111\/liv.15999","article-title":"Long-term Risk of Cardiovascular Disease Associated with MASLD and Different Cardiometabolic Risk Factors in IBD Patients: A Prospective Cohort Study","volume":"44","author":"Zhang","year":"2024","journal-title":"Liver Int."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1764","DOI":"10.1093\/ibd\/izz043","article-title":"Systematic Review with Meta-Analysis: Epidemiology of Nonalcoholic Fatty Liver Disease in Patients with Inflammatory Bowel Disease","volume":"25","author":"Zou","year":"2019","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Abenavoli, L., Spagnuolo, R., Scarlata, G.G.M., Scarpellini, E., Boccuto, L., and Luzza, F. (2023). Ultrasound Prevalence and Clinical Features of Nonalcoholic Fatty Liver Disease in Patients with Inflammatory Bowel Diseases: A Real-Life Cross-Sectional Study. Medicina, 59.","DOI":"10.3390\/medicina59111935"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1093\/ecco-jcc\/jjab212","article-title":"Inflammatory Bowel Disease-Associated Fatty Liver Disease: The Potential Effect of Biologic Agents","volume":"16","author":"Papaefthymiou","year":"2022","journal-title":"J. Crohns Colitis"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Adams, L.C., L\u00fcbbe, F., Bressem, K., Wagner, M., Hamm, B., and Makowski, M.R. (2018). Non-Alcoholic Fatty Liver Disease in Underweight Patients with Inflammatory Bowel Disease: A Case-Control Study. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0206450"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.1097\/MIB.0000000000000832","article-title":"Incidence and Predictors of Nonalcoholic Fatty Liver Disease by Serum Biomarkers in Patients with Inflammatory Bowel Disease","volume":"22","author":"Bessissow","year":"2016","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_10","first-page":"463","article-title":"High Prevalence of Non-Alcoholic Fatty Liver Disease in Patients with Inflammatory Bowel Disease Receiving Anti-Tumor Necrosis Factor Therapy","volume":"32","author":"Likhitsup","year":"2019","journal-title":"Ann. Gastroenterol."},{"key":"ref_11","first-page":"10633","article-title":"High Incidence of Non-Alcoholic Fatty Liver Disease in Patients with Crohn\u2019s Disease but Not Ulcerative Colitis","volume":"10","author":"Li","year":"2017","journal-title":"Int. J. Clin. Exp. Pathol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/s13679-023-00519-y","article-title":"The Role of Tumor Necrosis Factor-Alpha in the Pathogenesis and Treatment of Nonalcoholic Fatty Liver Disease","volume":"12","author":"Vachliotis","year":"2023","journal-title":"Curr. Obes. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1038\/nrgastro.2010.172","article-title":"The Role of the Gut Microbiota in Nonalcoholic Fatty Liver Disease","volume":"7","author":"Quigley","year":"2010","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Bischoff, S.C., Barbara, G., Buurman, W., Ockhuizen, T., Schulzke, J.D., Serino, M., Tilg, H., Watson, A., and Wells, J.M. (2014). Intestinal Permeability\u2014A New Target for Disease Prevention and Therapy. BMC Gastroenterol., 14.","DOI":"10.1186\/s12876-014-0189-7"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e94416","DOI":"10.1172\/jci.insight.94416","article-title":"Microbiota, Cirrhosis, and the Emerging Oral-Gut-Liver Axis","volume":"2","author":"Acharya","year":"2017","journal-title":"JCI Insight"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Gibiino, G., Sartini, A., Gitto, S., Binda, C., Sbrancia, M., Coluccio, C., Sambri, V., and Fabbri, C. (2021). The Other Side of Malnutrition in Inflammatory Bowel Disease (IBD): Non-Alcoholic Fatty Liver Disease. Nutrients, 13.","DOI":"10.3390\/nu13082772"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"5676","DOI":"10.3748\/wjg.v25.i37.5676","article-title":"Nonalcoholic Fatty Liver Disease in Patients with Inflammatory Bowel Disease: Beyond the Natural History","volume":"25","author":"Paduano","year":"2019","journal-title":"World J. Gastroenterol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.1093\/ibd\/izy051","article-title":"Nonalcoholic Fatty Liver Disease in Inflammatory Bowel Disease: Prevalence and Risk Factors","volume":"24","author":"Principi","year":"2018","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1093\/ibd\/izy200","article-title":"Screening for Nonalcoholic Fatty Liver Disease in Inflammatory Bowel Diseases: A Cohort Study Using Transient Elastography","volume":"25","author":"Restellini","year":"2019","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Yen, H.H., Su, P.Y., Huang, S.P., Wu, L., Hsu, T.C., Zeng, Y.H., and Chen, Y.Y. (2021). Evaluation of Non-Alcoholic Fatty Liver Disease in Patients with Inflammatory Bowel Disease Using Controlled Attenuation Parameter Technology: A Taiwanese Retrospective Cohort Study. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0252286"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1055\/s-0043-118666","article-title":"Pivotal Role of TNF-\u03b1 in the Development and Progression of Nonalcoholic Fatty Liver Disease in a Murine Model","volume":"50","author":"Kakino","year":"2018","journal-title":"Horm. Metab. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1097\/MIB.0000000000000209","article-title":"Metabolic Inflammation in Inflammatory Bowel Disease: Crosstalk between Adipose Tissue and Bowel","volume":"21","author":"Magro","year":"2015","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_23","first-page":"13916","article-title":"Anti-TNF Therapy and Immunogenicity in Inflammatory Bowel Diseases: A Translational Approach","volume":"13","author":"Genaro","year":"2021","journal-title":"Am. J. Trans. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"5A","DOI":"10.1155\/2005\/269076","article-title":"Toward an Integrated Clinical, Molecular and Serological Classification of Inflammatory Bowel Disease: Report of a Working Party of the 2005 Montreal World Congress of Gastroenterology","volume":"19","author":"Silverberg","year":"2005","journal-title":"Can. J. Gastroenterol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s10238-014-0323-4","article-title":"Metabolic Syndrome and Chronic Arthritis: Effects of Anti-TNF-\u03b1 Therapy","volume":"15","author":"Maruotti","year":"2015","journal-title":"Clin. Exp. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1007\/s10067-013-2369-1","article-title":"Impact of 24-Month Treatment with Etanercept, Adalimumab, or Methotrexate on Metabolic Syndrome Components in a Cohort of 210 Psoriatic Arthritis Patients","volume":"33","author":"Costa","year":"2014","journal-title":"Clin. Rheumatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e279","DOI":"10.1016\/j.crohns.2012.10.015","article-title":"Risk Factors of Non-Alcoholic Fatty Liver Disease in Patients with Inflammatory Bowel Disease","volume":"7","author":"Sourianarayanane","year":"2013","journal-title":"J. Crohns Colitis"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1016\/j.jhep.2017.02.001","article-title":"\u03927-Integrin and MAdCAM-1 Play Opposing Roles during the Development of Non-Alcoholic Steatohepatitis","volume":"66","author":"Drescher","year":"2017","journal-title":"J. Hepatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.cgh.2019.05.013","article-title":"Effects of Vedolizumab in Patients With Primary Sclerosing Cholangitis and Inflammatory Bowel Diseases","volume":"18","author":"Lynch","year":"2020","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"7367","DOI":"10.3748\/wjg.v26.i46.7367","article-title":"Prevalence and Risk Factors of Nonalcoholic Fatty Liver Disease in Patients with Inflammatory Bowel Diseases: A Cross-Sectional and Longitudinal Analysis","volume":"26","author":"Hoffmann","year":"2020","journal-title":"World J. Gastroenterol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1159\/000506938","article-title":"Sarcopenia Is a New Risk Factor of Nonalcoholic Fatty Liver Disease in Patients with Inflammatory Bowel Disease","volume":"38","author":"Kang","year":"2020","journal-title":"Dig. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1038\/s41419-017-0124-2","article-title":"Non-Alcoholic Fatty Liver Disease Phenotypes in Patients with Inflammatory Bowel Disease Article","volume":"9","author":"Sartini","year":"2018","journal-title":"Cell Death Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1097\/MEG.0b013e328325d42b","article-title":"Effects of Tumor Necrosis Factor Alpha Inhibition with Infliximab on Lipid Levels and Insulin Resistance in Patients with Inflammatory Bowel Disease","volume":"21","author":"Koutroubakis","year":"2009","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1002\/ibd.21669","article-title":"Changing Shape of Disease: Nonalcoholic Fatty Liver Disease in Crohn\u2019s Disease\u2014A Case Series and Review of the Literature","volume":"18","author":"McGowan","year":"2012","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3002","DOI":"10.1111\/jgh.15631","article-title":"Circulating Tumor Necrosis Factor-\u03b1 Levels in Non-Alcoholic Fatty Liver Disease: A Systematic Review and a Meta-Analysis","volume":"36","author":"Potoupni","year":"2021","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.metabol.2010.09.003","article-title":"Serum Total Adiponectin in Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis","volume":"60","author":"Polyzos","year":"2011","journal-title":"Metabolism"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1007\/s00125-015-3769-3","article-title":"Circulating Leptin in Non-Alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis","volume":"59","author":"Polyzos","year":"2016","journal-title":"Diabetologia"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"203","DOI":"10.5114\/pg.2017.70474","article-title":"High Serum N-Terminal Propeptide of Procollagen Type III Concentration Is Associated with Liver Diseases","volume":"3","author":"Gudowska","year":"2017","journal-title":"Gastroenterol. Rev."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Osawa, Y., Hoshi, M., Yasuda, I., Saibara, T., Moriwaki, H., and Kozawa, O. (2013). Tumor Necrosis Factor-\u03b1 Promotes Cholestasis-Induced Liver Fibrosis in the Mouse through Tissue Inhibitor of Metalloproteinase-1 Production in Hepatic Stellate Cells. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0065251"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s00441-011-1246-y","article-title":"TGF-\u03b2 in Progression of Liver Disease","volume":"347","author":"Dooley","year":"2012","journal-title":"Cell Tissue Res."},{"key":"ref_41","unstructured":"European Medicines Agency (EMA) (2024, August 24). ICH E6 (R2) Good Clinical Practice\u2014Scientific Guideline, Available online: https:\/\/www.ema.europa.eu\/en\/ich-e6-r2-good-clinical-practice-scientific-guideline."},{"key":"ref_42","unstructured":"World Medical Association Declaration of Helsinki (2013). Ethical Principles for Scientific Requirements and Research Protocols. Bull. World Health Organ., 79, 373."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1093\/ecco-jcc\/jjz180","article-title":"ECCO Guidelines on Therapeutics in Crohn\u2019s Disease: Medical Treatment","volume":"14","author":"Torres","year":"2020","journal-title":"J. Crohns Colitis"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1093\/ecco-jcc\/jjab178","article-title":"ECCO Guidelines on Therapeutics in Ulcerative Colitis: Medical Treatment","volume":"16","author":"Raine","year":"2022","journal-title":"J. Crohns Colitis"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1016\/j.clnu.2019.11.002","article-title":"ESPEN Practical Guideline: Clinical Nutrition in Inflammatory Bowel Disease","volume":"39","author":"Bischoff","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1136\/gut.2005.082909","article-title":"The Montreal Classification of Inflammatory Bowel Disease: Controversies, Consensus, and Implications","volume":"55","author":"Satsangi","year":"2006","journal-title":"Gut"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/S0016-5085(76)80163-1","article-title":"Development of a Crohn\u2019s Disease Activity Index. National Cooperative Crohn\u2019s Disease Study","volume":"70","author":"Best","year":"1976","journal-title":"Gastroenterology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/S0016-5107(04)01878-4","article-title":"Development and Validation of a New, Simplified Endoscopic Activity Score for Crohn\u2019s Disease: The SES-CD","volume":"60","author":"Daperno","year":"2004","journal-title":"Gastrointest. Endosc."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2708","DOI":"10.1111\/j.1572-0241.2007.01526.x","article-title":"The Severity of Ultrasonographic Findings in Nonalcoholic Fatty Liver Disease Reflects the Metabolic Syndrome and Visceral Fat Accumulation","volume":"102","author":"Hamaguchi","year":"2007","journal-title":"Am. J. Gastroenterol."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Bedogni, G., Bellentani, S., Miglioli, L., Masutti, F., Passalacqua, M., Castiglione, A., and Tiribelli, C. (2006). The Fatty Liver Index: A Simple and Accurate Predictor of Hepatic Steatosis in the General Population. BMC Gastroenterol., 6.","DOI":"10.1186\/1471-230X-6-33"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1002\/hep.21496","article-title":"The NAFLD Fibrosis Score: A Noninvasive System That Identifies Liver Fibrosis in Patients with NAFLD","volume":"45","author":"Angulo","year":"2007","journal-title":"Hepatology"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1007\/BF00280883","article-title":"Homeostasis Model Assessment: Insulin Resistance and \u03b2-Cell Function from Fasting Plasma Glucose and Insulin Concentrations in Man","volume":"28","author":"Matthews","year":"1985","journal-title":"Diabetologia"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1136\/gut.2010.216077","article-title":"Simple Non-Invasive Fibrosis Scoring Systems Can Reliably Exclude Advanced Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease","volume":"59","author":"McPherson","year":"2010","journal-title":"Gut"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.dld.2009.08.002","article-title":"Hepatic Steatosis Index: A Simple Screening Tool Reflecting Nonalcoholic Fatty Liver Disease","volume":"42","author":"Lee","year":"2010","journal-title":"Dig. Liver Dis."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.3758\/BRM.41.4.1149","article-title":"Statistical Power Analyses Using G*Power 3.1: Tests for Correlation and Regression Analyses","volume":"41","author":"Erdfelder","year":"2009","journal-title":"Behav. Res. Methods"}],"container-title":["Pharmaceuticals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8247\/17\/11\/1432\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:20:50Z","timestamp":1760113250000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8247\/17\/11\/1432"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,25]]},"references-count":55,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["ph17111432"],"URL":"https:\/\/doi.org\/10.3390\/ph17111432","relation":{},"ISSN":["1424-8247"],"issn-type":[{"value":"1424-8247","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,25]]}}}