Methotrexate and biological therapy are not associated with fatty liver in rheumatoid arthritis-a cross-sectional study.

IF 2.9 3区 医学 Q2 RHEUMATOLOGY
Tatjana Zekić, Filip Blažić, Nataša Katalinić, Nada Starčević Čizmarević, Aleksandar Čubranić
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引用次数: 0

Abstract

The prevalence of non-alcoholic fatty liver disease (NAFLD) in patients with rheumatoid arthritis (RA) is approximately 30%. The relationship between conventional synthetic and biologic disease-modifying antirheumatic drugs (csMDARDs and bDMARDs) and NAFLD is complex and requires careful consideration in clinical practice. This study evaluates the impact of various treatment regimens and analyzes the relationship between NAFLD, defined by a controlled attenuation parameter (CAP) threshold of 275 dB/m, and liver fibrosis (liver stiffness measurement > 8 kPa) and clinical parameters in 170 RA patients. Treatment groups were categorized based on methotrexate (MTX) use ("YES" and "NO") and the use of biologic agents, including tumor necrosis factor inhibitors (TNFi), interleukin-6 (IL-6) inhibitors, as well as non-treatment groups. The prevalence of NAFLD in RA patients was found to be 36%, primarily attributed to components of metabolic syndrome and obesity including body-mass index (BMI), waist (WC) and hip circumference (HC), alanine aminotransferase (ALT), aspartate aminotransferase (AST) (all p < .001) triglycerides (p = .049). No significant differences in NAFLD prevalence were observed between treatment groups or between MTX treatment groups (cumulative doses < 3 g and > 3 g; p = 1.0). Furthermore, TNFi treatment duration did not show a significant correlation with NAFLD (Spearman's rho = 0.024, p = .897) or with fibrosis severity (Spearman's rho = 0.087, p = .640). In contrast, the duration of IL-6 inhibitor treatment demonstrated a significant negative correlation with NAFLD (Pearson's r=-0,41, p = .029). Methotrexate does not appear to influence NAFLD or fibrosis in RA patients. In contrast, long-term use of IL-6 receptor inhibitors may contribute to a reduction in NAFLD.

甲氨蝶呤和生物治疗与类风湿关节炎脂肪肝无关——横断面研究。
类风湿性关节炎(RA)患者的非酒精性脂肪性肝病(NAFLD)患病率约为30%。传统合成及生物制疾病缓解类抗风湿药物(csMDARDs和bDMARDs)与NAFLD的关系复杂,在临床实践中需要慎重考虑。本研究评估了各种治疗方案的影响,并分析了170例RA患者NAFLD(由控制衰减参数(CAP)阈值275 dB/m定义)与肝纤维化(肝刚度测量> 8 kPa)和临床参数之间的关系。治疗组根据甲氨蝶呤(MTX)的使用(“YES”和“NO”)和生物制剂的使用(包括肿瘤坏死因子抑制剂(TNFi)、白细胞介素-6 (IL-6)抑制剂)以及非治疗组进行分类。RA患者中NAFLD的患病率为36%,主要归因于代谢综合征和肥胖的组成部分,包括身体质量指数(BMI)、腰围(WC)和臀围(HC)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)(均p 3g; p = 1.0)。此外,TNFi治疗时间与NAFLD无显著相关性(Spearman’s rho = 0.024, p =。897)或纤维化严重程度(Spearman’s rho = 0.087, p = 0.640)。相反,IL-6抑制剂治疗时间与NAFLD呈显著负相关(Pearson’s r=-0,41, p = 0.029)。甲氨蝶呤似乎不会影响类风湿关节炎患者的NAFLD或纤维化。相反,长期使用IL-6受体抑制剂可能有助于减少NAFLD。
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来源期刊
Rheumatology International
Rheumatology International 医学-风湿病学
CiteScore
7.30
自引率
5.00%
发文量
191
审稿时长
16. months
期刊介绍: RHEUMATOLOGY INTERNATIONAL is an independent journal reflecting world-wide progress in the research, diagnosis and treatment of the various rheumatic diseases. It is designed to serve researchers and clinicians in the field of rheumatology. RHEUMATOLOGY INTERNATIONAL will cover all modern trends in clinical research as well as in the management of rheumatic diseases. Special emphasis will be given to public health issues related to rheumatic diseases, applying rheumatology research to clinical practice, epidemiology of rheumatic diseases, diagnostic tests for rheumatic diseases, patient reported outcomes (PROs) in rheumatology and evidence on education of rheumatology. Contributions to these topics will appear in the form of original publications, short communications, editorials, and reviews. "Letters to the editor" will be welcome as an enhancement to discussion. Basic science research, including in vitro or animal studies, is discouraged to submit, as we will only review studies on humans with an epidemological or clinical perspective. Case reports without a proper review of the literatura (Case-based Reviews) will not be published. Every effort will be made to ensure speed of publication while maintaining a high standard of contents and production. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
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