ArticleInternational journal of medical sciences2026
Eosinophilic Esophagitis and Risk of Non-Alcoholic Fatty Liver Disease and Cirrhosis: A Multi-Center Retrospective Study.
Article in International journal of medical sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and Aim: Eosinophilic esophagitis (EoE) is a chronic Th2-mediated inflammatory disease. Given its systemic immune activation and eosinophil-rich pathology, this study aimed to evaluate the longitudinal risk of non-alcoholic fatty liver disease (NAFLD) and cirrhosis among patients with EoE. Methods: A retrospective cohort study was conducted using the TriNetX US Collaborative Network. Adults (≥18 years) with an EoE diagnosis were matched 1:1 with EoE-free controls based on demographics, comorbidities, and healthcare utilization. Patients with prior liver disease or malignancy were excluded. Incident NAFLD and cirrhosis were evaluated excluding diagnoses within 3 months of the index date. Sensitivity analyses explored alternative EoE definitions (proton pump inhibitor use, topical corticosteroids, endoscopy records) and longer wash-out periods. Results: Compared with matched controls, EoE patients had a significantly elevated risk of NAFLD (HR = 1.409, 95% CI: 1.277-1.555) and cirrhosis (HR = 1.529, 95% CI: 1.176-1.988). Elevated risks persisted using PPI-based (NAFLD: HR = 1.705, 95% CI: 1.535-1.894; cirrhosis: HR = 1.962, 95% CI: 1.478-2.605), steroid-based (NAFLD: HR = 1.746, 95% CI: 1.561-1.953; cirrhosis: HR = 2.101, 95% CI: 1.557-2.837), and endoscopy-based definitions (NAFLD: HR = 1.951, 95% CI: 1.506-2.528). Conclusions: EoE is associated with higher long-term risks of NAFLD and cirrhosis. These findings underscore the importance of hepatic surveillance and immune-metabolic research in EoE patients. However, potential residual confounder caused by comedications should be cautiously interpreted.
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