Grant: Project Grant

Steatotic liver disease, formerly called fatty liver, is the most common liver problem in Canada, affecting 8 million people. It is linked to rising obesity and diabetes. This build-up of fat in the liver can silently lead to scarring (fibrosis), liver cancer and even the need for liver transplant, often without any warning signs. Our research shows that steatotic liver disease is especially common in Canadians with inflammatory bowel disease (IBD), affecting 40% of patients. This may result from long-term use of IBD medications or intestinal inflammation. Obesity and diabetes are also becoming more frequent in people with IBD, partly because treatments are more effective and patients are living longer and healthier lives, often with modern lifestyle patterns that increase metabolic risk. Despite this risk, steatotic liver disease is not routinely assessed in IBD care, and doctors do not know yet which patients are most likely to develop serious liver damage. This is an important gap in care. Our team has pioneered the use of FibroScan, a safe, painless ultrasound test that accurately measures both liver fat and early signs of fibrosis without the need for a liver biopsy. In this study, we will follow 1284 patients with IBD across four Canadian provinces for five years using FibroScan, to track how steatotic liver disease evolves and who is most likely to develop liver fibrosis. We will examine IBD type and duration, treatment history, metabolic health, sex-specific risks such as early menopause, and life circumstances like income or social support. We will also measure how the disease affects quality of life. Our goal is to develop a personalized "risk score" to help doctors identify high-risk patients early, so they can monitor liver health, intervene sooner, and guarantee better long-term outcomes. We hope that our research will help bring liver screening into routine IBD care and improve the lives of thousands of Canadians who suffer from IBD.