360 - Prevalence of Non Alcoholic Fatty Liver Disease in Rheumatoid Arthritis

Nina Bhambhani, Mona Amin, Jose Gutierrez, Girolamo Cuppari, Eddys Disla. Cabrini Medical Center-Mount Sinai Shool of Medicine, New York, NY
Presentation Number: 360

Purpose: To describe the prevalence of nonalcoholic fatty liver disease (NAFLD) in a cohort of rheumatoid arthritis (RA) patients. NAFLD is an increasingly recognized condition that may progress to end-stage liver disease. Its prevalence in RA is not known, but is increased in other inflammatory disorders such as ulcerative colitis and Crohn’s disease.1 Patients with RA are often treated with drugs associated with significant hepatotoxicity. Traditionally, liver enzymes are used to assess liver function before initiating methotrexate, although this approach at times may overlook the presence of NAFLD. In the ACR recommendations for monitoring hepatic safety in RA patients receiving methotrexate, an abdominal ultrasound is not routinely recommended. This study examines the prevalence NAFLD in a cohort of RA patients using ultrasonography.
Methods: We obtained a baseline abdominal ultrasound in 100 consecutive RA patients, before starting them on methotrexate. We excluded patients who were alcohol users or had a history of viral hepatitis. We compared them to another 100 patients referred for abdominal ultrasound with a non RA diagnosis. They were matched for age, sex, history of diabetes and BMI. Student t-test and Chi-square test were used to compare means and distribution frequencies, respectively.
Results:
nAge*FemaleBMI*DMNAFLD
RA10060.1±149126.9±41923
Non-RA10060.1±158126.5±32215
p0.710.650.40.730.15
*mean±standard deviation BMI=body mass index DM=diabetes mellitus

Conclusion: NAFLD was a common finding in RA patients when compared with patients with similar comorbidities, although not reaching statistical significance. The prevalence of NAFLD in our RA group was on the high end of the reported 10-24% prevalence in the general population of various countries.1 Identifying NAFLD by ultrasound may add safety to the choice of drugs selected to manage RA, although more studies are needed in this area.
1 Angulo, P. Nonalcoholic Fatty Liver Disease. New England Journal of Medicine, Vol.346, No.16, April 18, 2002:1221-1231.

 N. Bhambhani, None; M. Amin, None; J. Gutierrez, None; G. Cuppari, None; E. Disla, None.