Assessment Of the Prevalence and Clinical Features Of Non-Alcoholic Fatty Liver Disease In Patients With Rheumatoid Arthritis | American Journal Of Biomedical Science & Pharmaceutical Innovation

Authors

Fazilat N. Shukurova

Department of Propaedeutics of Internal Medicine No. 2 Doctoral student (DSc.) Tashkent, Tashkent Medical Academy Uzbekistan
Marif Sh. Karimov

Department of Propaedeutics of Internal Medicine No. professor Tashkent, Tashkent Medical Academy Uzbekistan

DOI:

https://doi.org/10.37547/ajbspi/Volume06Issue05-08

Keywords:

Rheumatoid arthritis chronic diffuse liver diseases nonalcoholic fatty liver disease (NAFLD)

Abstract

Purpose: Many studies confirm the close association between non-alcoholic fatty liver disease (NAFLD) and diffuse connective tissue diseases, such as rheumatoid arthritis (RA). However, this connection has not been systematically analyzed, and there is a significant need in modern medicine for a comprehensive study of the prevalence and course of NAFLD in patients with RA. Therefore, the aim of our study was to develop methods for predicting the prevalence of NAFLD in RA, as well as its clinical course and the development of fibrosis.

Methods: The study included 46 patients with RA, in whom the diagnosis of NAFLD was established based on ultrasound examination. Steatosis and fibrosis indices were calculated for all participants using appropriate scales, and clinical and laboratory tests (medical history, anthropometry, clinical examination, etc.) were performed.

Results: Reliable data were obtained on the prevalence and clinical course of NAFLD in patients with RA. Steatosis was diagnosed in one-third of RA patients, while two-thirds had steatohepatitis. Fibrosis was also detected in one-third of the patients, indicating possible progression.

Conclusion: In patients with both RA and NAFLD, a significant correlation was found between RA activity, its duration, body mas index, lipid metabolism, liver transaminase levels, as well as liver steatosis and fibrosis.

References

Gordeev A.V., Galushko E.A., Nasonov E.L. The concept of multimorbidity in rheumatology practice. Scientific and Practical Rheumatology. 2014;52(4):362–65.

Ivashkin V.T., Drapkina O.M., Korneeva O.N. Clinical variants of metabolic syndrome. Moscow, 2011. 208 pages.

Karateev A.E., Gontarenko N.V., Tsurkan A.V. Comorbid pathology of the gastrointestinal system in patients with rheumatic diseases: not just NSAID-induced gastropathy. Scientific and Practical Rheumatology. 2016;54(4):382–89.

Lazebnik L.B., Golovanova E.V., Turkina S.V., Raichelson K.L., Okovity S.V., Drapkina O.M., et al. Non-alcoholic fatty liver disease in adults: clinical presentation, diagnosis, and treatment. Recommendations for physicians, third version. Experimental and Clinical Gastroenterology. 2021;185(1):4–52.

Nasonov E.L., Gordeev A.V., Galushko E.A. Rheumatic diseases and multimorbidity. Therapeutic Archive. 2015;(5):4–9.

Nasonov E.L., Karateev D.E., Chichasova N.V. EULAR recommendations for rheumatoid arthritis treatment-2013: general overview and discussed issues. Scientific and Practical Rheumatology. 2013;51(6):609–22.

Nikitina N.M., Afanasyev I.A., Rebrov A.P. Comorbidity in patients with rheumatoid arthritis. Scientific and Practical Rheumatology. 2015;53(2):149–54.

Panafidina T.A., Kondratyeva L.V., Gerasimova E.V., et al. Comorbidity in rheumatoid arthritis. Scientific and Practical Rheumatology. 2014;52(3):283–89.

Barnett K., Mercer S.W., Norbury M., et al. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012;380(9836):37–43. Doi: 10.1016/S0140-6736(12)60240-2.

Brunt E.M., Wong V.W., Nobili V., et al. Nonalcoholic fatty liver disease. Nat Rev Dis Primers. 2015;1:15080. doi: 10.1038/nrdp.2015.80.

Dyson J.K., Anstee Q.M., McPherson S. Nonalcoholic fatty liver disease: a practical approach to diagnosis and staging. Frontline Gastroenterol. 2014;5(3):211–18. Doi: 10.1136/flgastro-2013-100403.

EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. Hepatol. 2016;64(6):1388–402. Doi: 10.1016/j.jhep.2015.11.004.

Eslam M., Newsome P.N., Sarin S.K., Anstee Q.M., Targher G., Romero-Gomez M. et al. A new definition for metabolic associated fatty liver disease: an international expert consensus statement. J. Hepatol. 2020;73(1):202209. DOI: 10.1016/j.jhep.2020.03.039

Ekstedt M., Hagström H., Nasr P., et al. Fibrosis stage in the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up. Hepatol. 215;61(5):1547–54. Doi: 10.1002/hep. 27368.

Gabriel S.E., Michaud K. Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases. Arthr Res Ther. 2009;11(3):22–9. Doi: 10.1186/ar2669.

Lahiri M., Morgan C., Symmons D., Bruce I.N. Modifiable risk factors for RA: prevention, better than cure. Rheumatol 2012;51:499–512. Doi: 10.1093/rheumatology/ker299.

Lеоnardo A., Ballestri S., Marchesini G., et al. Nonalcoholic fatty liver disease: A precursor of the metabolic syndrome. Dig Liver Dis. 2015;47(3):181–90. Doi: 10.1016/j.dld.2014.09.020.

Sandberg M.E.G., et al. Overweight decreases the chance of achieving good respons and low disease activity in early rheumatoid arthritis Ann. Rheum. Dis. 2014;73:2029–33. Doi: 10.1136/аnnrheumdis-2013-205094.

Urgens M.S., Jacobs J.W., Bijlsma J.W. The use of conventional disease-modifying anti-rheumatic drugs in established RA. Best Pract Res Clin Rheumatol. 2011;25(4):523–33. Doi: 10.1016/j.berh.2011.10.006.

Younossi Z.M., Koenig A.B., Abdelatif D., et al. Global epidemiology of nonalcoholic fatty liver disease-meta-analytic assessment of prevalence, incidence, and outcomes. Hepatol. 2016;64(1):73–84. Doi: 10.1002/hep.28431