Liver steatosis in patients with rheumatoid arthritis treated with methotrexate is associated with body mass index
作者机构：Department of Gastroenterology ServiceDonostia University HospitalDonostia 20014Spain Department of RheumatologyDonostia University HospitalDonostia 20014Spain Department of GastroenterologyDonostia University HospitalDonostia 20014Spain Department of Clinical EpidemiologyDonostia University HospitalDonostia 20014Spain
出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)
年 卷 期：2023年第15卷第5期
页 面：699-706页
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
摘 要：BACKGROUND Methotrexate(MTX)is the usual first-line treatment for rheumatoid arthritis(RA).Long-term use of MTX has been associated with liver steatosis(LS)and liver fibrosis(LF).AIM To determine if LS in patients treated with MTX for RA is associated with MTX cumulative dose(MTX-CD),metabolic syndrome(Mt S),body mass index(BMI),the male sex,or *** A single-center,prospective study of patients receiving MTX for RA was performed from February 2019 to February *** inclusion criteria were patients aged 18 years or older diagnosed with RA by a rheumatologist and being treated with MTX(without limitation on the duration of treatment).The exclusion criteria were previous diagnosis of liver disease(hepatitis B or C virus infection,known nonalcoholic fatty liver disease),alcohol consumption greater than 60 g/d in males or 40 g/d in females,human immunodeficiency virus infection on antiretroviral therapy,diabetes mellitus,chronic renal failure,congestive heart failure,or BMI greater than 30 kg/m^(2).Patients receiving leflunomide in the 3 years prior to the study were also *** elastography(Fibro Scan,Echosens?,Paris,France)was used for fibrosis determination(LF7 Kp A)and computer attenuation parameter(CAP)for LS(CAP248 d B/m).Demographic variables,laboratory data,MTX-CD(4000 mg),Mt S criteria,BMI(25),transient elastography,and CAP scores were collected from all *** Fifty-nine patients were ***-three were female(72.88%),and the mean age was 61.52 years(standard deviation:11.73).When we compared MTX-CD≤4000 mg(26 patients;14 with LS and 12 without)with4000 mg(33 patients;12 with LS and 21 without),no statistical differences were found(P=0.179).We compared CAP scores stratified by Mt S,BMI,sex,and *** were no significant differences in CAP scores based on the presence of Mt S[CAP/Mt S:50 no Mt S(84.75%);9 Mt S(15.25%);P=0.138],the male sex(CAP/sex:8 male/18 female LS;8 male/25 female no LS;P=0.576),or LF[CAP/fibrosis:
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