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Abstract Details
Prevalence of Steatotic Liver Disease Among US Adults with Rheumatoid Arthritis
Dig Dis Sci. 2024 Jan 6. doi: 10.1007/s10620-023-08225-4. Online ahead of print.
1Division of Internal Medicine, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA.
2Houston Methodist Research Institute, Houston, TX, USA.
3Department of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece.
4Division of Gastroenterology and Hepatology, Providence VA Medical Center, Providence, RI, USA.
5Liver Research Center, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
6Department of Medicine, Houston Methodist Hospital, Smith Tower 1001, Fannin, Houston, TX, 6550, 77030, USA. emylonakis@houstonmethodist.org.
#Contributed equally.
Abstract
Background: The prevalence of steatotic liver disease (SLD) among patients with rheumatoid arthritis (RA) remains largely unknown.
Aims: To investigate the prevalence of SLD and liver fibrosis among patients with RA.
Methods: We utilized data from the United States (US)-based National Health and Nutrition Examination Survey (NHANES) 2017-2020 cycle. After applying established sample weights, we estimated the age-adjusted prevalence of SLD and its subclassifications (CAP ≥ 285 dB/m), high-risk NASH (FAST score) and liver fibrosis (LSM) among participants with self-reported RA. Multivariable logistic regression was performed to identify independent risk factors for metabolic dysfunction associated SLD (MASLD), high-risk NASH and fibrosis, respectively, among participants with RA. We present adjusted odds ratios (aORs) and 95% confidence intervals (CIs).
Results: Age-adjusted prevalence of MASLD among US adults with RA was 34.91% (95% CI: 24.02-47.65%). We also found that the age-adjusted prevalence of high-risk NASH (FAST score > 0.35) and significant fibrosis (LSM > 8.6 kPa) was 12.97% (95% CI: 6.89-23.07%) and 10.35% (95% CI: 5.55-18.48%), respectively. BMI ≥ 30 kg/m2, (aOR 6.23; 95% CI: 1.95-19.88), diabetes (aOR 5.90; 95% CI: 1.94-17.94), and dyslipidemia (aOR 2.83; 95% CI: 1.12-7.11) were independently associated with higher odds of MASLD among participants with RA. Diabetes (aOR 19.34; 95% CI: 4.69-79.70) was also independently associated with high-risk NASH.
Conclusions: The prevalence of MASLD, high-risk NASH, and liver fibrosis among patients with RA is equal or higher than the general population. Future studies of large cohorts are needed to substantiate the role of systemic inflammation in the pathophysiology of MASLD.