Rheumatoid arthritis is independently associated with metabolic Dysfunction-Associated steatotic liver disease: evidence from the paracelsus 10,000 Population-Based cohort study.

IF 2.9 3区医学 Q2 RHEUMATOLOGY

Rheumatology International Pub Date : 2025-10-06 DOI:10.1007/s00296-025-06002-2

Mathias Ausserwinkler, Axel J Hueber, Sophie Gensluckner, Bernhard Paulweber, Eugen Trinka, Patrick Langthaler, Christian Datz, Andreas Voelkerer, Franz Singhartinger, Bernhard Iglseder, Maria Flamm, Elmar Aigner, Bernhard Wernly

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引用次数: 0

Abstract

Background: Rheumatoid arthritis (RA) is associated with systemic inflammation and increased risk of cardiovascular and metabolic comorbidities. The relationship between RA and metabolic dysfunction-associated steatotic liver disease (MASLD) has not been established in population-based studies.

Methods: We conducted a cross-sectional analysis of 6638 participants from the population-based Paracelsus 10,000 cohort in Austria, including 187 individuals with physician-diagnosed RA meeting ACR/EULAR classification criteria. MASLD was defined using the Fatty Liver Index (≥ 60) combined with cardiometabolic risk factors according to 2024 EASL guidelines. We used Poisson regression models with sequential adjustment for demographic factors, metabolic syndrome, lifestyle factors, NSAID use, and cardiovascular risk (SCORE2). Liver fibrosis risk was assessed using the Fibrosis-4 Index (FIB-4).

Results: MASLD prevalence was higher in RA patients than controls (41.2% vs. 28.5%, P < 0.001). In sequential regression models, the association between RA and MASLD persisted after adjustment for demographics (IRR, 1.55; 95% CI 1.33-1.82), metabolic and lifestyle factors (IRR, 1.20; 95% CI 1.03-1.40), and cardiovascular risk factors (IRR, 1.35; 95% CI 1.14-1.60; P < 0.001). In addition, RA patients showed elevated liver fibrosis markers (median FIB-4: 1.21 vs. 1.08; P < 0.001).

Conclusions: In this population-based cohort, RA was independently associated with a 35% increased risk of MASLD and elevated liver fibrosis markers. These findings suggest that systematic liver assessment should be considered in the routine care of RA patients.

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类风湿关节炎与代谢功能障碍相关的脂肪变性肝病独立相关：来自paracelsus 10,000人群队列研究的证据

背景：类风湿性关节炎（RA）与全身性炎症以及心血管和代谢合并症的风险增加有关。RA与代谢功能障碍相关的脂肪变性肝病（MASLD）之间的关系尚未在基于人群的研究中得到证实。方法：我们对6638名来自奥地利以人群为基础的Paracelsus 10,000队列的参与者进行了横断面分析，其中包括187名医生诊断为符合ACR/EULAR分类标准的RA患者。根据2024年EASL指南，使用脂肪肝指数（≥60）结合心脏代谢危险因素来定义MASLD。我们使用泊松回归模型，对人口统计学因素、代谢综合征、生活方式因素、非甾体抗炎药使用和心血管风险（SCORE2）进行顺序调整。采用纤维化-4指数（FIB-4）评估肝纤维化风险。结果：类风湿关节炎患者的MASLD患病率高于对照组（41.2% vs. 28.5%）。结论：在这个基于人群的队列中，类风湿关节炎与MASLD风险增加35%和肝纤维化标志物升高独立相关。这些发现提示在RA患者的常规护理中应考虑系统的肝脏评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

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.