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The Use of an Effective Scale in the Evaluation of Hepatosteatosis in Psoriatic Arthritis: Tissue Attenuation Imaging

Year 2024, , 136 - 141, 20.08.2024
https://doi.org/10.24938/kutfd.1394513

Abstract

Objective: Psoriatic arthritis (PsA) is a chronic destructive arthropathy with various types of joint involvement, which presents challenges in treatment management. Non-alcoholic fatty liver disease (NAFLD) is a common comorbidity in patients with psoriatic arthritis. This study aims to evaluate the sensitivity of Tissue Attenuation Imaging (TAI) scores for NAFLD in PsA patients and assess their correlation with disease activity and laboratory values.
Material and Methods: The study was conducted in collaboration with the Rheumatology and Radiology clinics of Gazi University from January 2023 to July 2023. A total of 25 PsA patients diagnosed according to CLASsification for Psoriatic ARthritis (CASPAR) criteria were included. Demographic data, disease activities, and laboratory values of the patients were recorded. TAI scores were compared between groups with and without NAFLD.
Results: TAI scores were significantly higher in PsA patients with NAFLD (p=0.006). GGT, ESR (erythrocyte sedimentation rate), and hemoglobin levels were higher in those with NAFLD (p=0.002, 0.004 and 0.019). TAI score showed a positive correlation with triglyceride, GGT, and ESR values
Conclusion: This study demonstrates the effectiveness of TAI scores in evaluating NAFLD in PsA patients. This non-invasive and quantitative assessment method, can aid in the monitoring of patients. Early detection of NAFLD in PsA patients is crucial to prevent complications.

References

  • Brockbank J, Gladman D. Diagnosis and management of psoriatic arthritis. Drugs. 2002;62(17):2447-2457.
  • Gladman DD, Shuckett R, Russell ML, Thorne JC, Schachter RK. Psoriatic arthritis (PSA)--An analysis of 220 patients. Q J Med. 1987;62(238):127-141.
  • Gladman DD. Current concepts in psoriatic arthritis. Curr Opin Rheumatol. 2002;14(4):361-366.
  • Miele L, Vallone S, Cefalo C, et al. Prevalence, characteristics and severity of non-alcoholic fatty liver disease in patients with chronic plaque psoriasis. J Hepatol. 2009;51(4):778-786.
  • Diani M, Altomare G, Reali E. T Helper Cell Subsets in clinical manifestations of psoriasis. J Immunol Res. 2016;7692024.
  • Benham H, Norris P, Goodall J, et al. Th17 and Th22 cells in psoriatic arthritis and psoriasis. Arthritis Res Ther. 2013;15(5):R136.
  • Barr RG. Ultrasound of diffuse liver disease ıncluding elastography. Radiol Clin North Am. 2019;57(3):549-562.
  • Ferraioli G, Berzigotti A, Barr RG, et al. Quantification of liver fat content with ultrasound: A WFUMB position paper. Ultrasound Med Biol. 2021;47(10):2803-2820.
  • Şendur HN, Özdemir Kalkan D, Cerit MN, Kalkan G, Şendur AB, Özhan Oktar S. Hepatic fat quantification with novel ultrasound based techniques: A diagnostic performance study using magnetic resonance imaging proton density fat fraction as reference standard. Can Assoc Radiol J. 2023;74(2):362-369.
  • Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H; CASPAR Study Group. Classification criteria for psoriatic arthritis: Development of new criteria from a large international study. Arthritis Rheum. 2006;54(8):2665-2673.
  • Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new approach to defining disease status in ankylosing spondylitis: The Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol. 1994;21(12):2286-2291.
  • Fransen J, van Riel PL. The Disease Activity Score and the EULAR response criteria. Clin Exp Rheumatol. 2005;23(5 Suppl 39):S93-99.
  • Fredriksson T, Pettersson U. Severe psoriasis--oral therapy with a new retinoid. Dermatologica. 1978;157(4):238-244.
  • Griffiths CEM, Armstrong AW, Gudjonsson JE, Barker JNWN. Psoriasis. Lancet. 2021;397(10281):1301-1315.
  • Gladman DD, Antoni C, Mease P, Clegg DO, Nash P. Psoriatic arthritis: Epidemiology, clinical features, course, and outcome. Ann Rheum Dis. 2005;64 Suppl 2(Suppl 2):ii14-17.
  • Mease PJ, Gladman DD, Papp KA, et al. Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European/North American dermatology clinics. J Am Acad Dermatol. 2013;69(5):729-735.
  • Kalyoncu U, Bayindir Ö, Ferhat Öksüz M, et al. Psoriatic Arthritis Registry of Turkey Study Group. The Psoriatic Arthritis Registry of Turkey: Results of a multicentre registry on 1081 patients. Rheumatology (Oxford). 2017;56(2):279-286
  • Fransen J, van Riel PL. The disease activity Score and the EULAR response criteria. Clin Exp Rheumatol. 2005 Sep- Oct;23(5 Suppl 39):S93-99.
  • Gladman DD, Ang M, Su L, Tom BD, Schentag CT, Farewell VT. Cardiovascular morbidity in psoriatic arthritis. Ann Rheum Dis. 2009;68(7):1131-1135.
  • Jamnitski A, Symmons D, Peters MJ, Sattar N, McInnes I, Nurmohamed MT. Cardiovascular comorbidities in patients with psoriatic arthritis: A systematic review. Ann Rheum Dis. 2013;72(2):211-216.
  • Kaine J, Song X, Kim G, Hur P, Palmer JB. Higher ıncidence rates of comorbidities in patients with psoriatic arthritis compared with the general population using U.S. Administrative Claims Data. J Manag Care Spec Pharm. 2019;25(1):122-132.
  • Luken PC. Social identity in later life: a situational approach to understanding old age stigma. Int J Aging Hum Dev. 1987;25(3):177-193.
  • Bellinato F, Gisondi P, Mantovani A, Girolomoni G, Targher G. Risk of non-alcoholic fatty liver disease in patients with chronic plaque psoriasis: An updated systematic review and meta-analysis of observational studies. J Endocrinol Invest. 2022;45(7):1277-1288.
  • Haroon M, Rafiq Chaudhry AB, Fitzgerald O. Higher prevalence of metabolic syndrome in patients with psoriatic arthritis: A comparison with a control group of noninflammatory rheumatologic conditions. J Rheumatol. 2016;43(2):463-464.
  • Haroon M, Gallagher P, Heffernan E, FitzGerald O. High prevalence of metabolic syndrome and of insulin resistance in psoriatic arthritis is associated with the severity of underlying disease. J Rheumatol. 2014;41(7):1357-1365.
  • Pakchotanon R, Ye JY, Cook RJ, Chandran V, Gladman DD. Liver abnormalities in patients with psoriatic arthritis. J Rheumatol. 2020;47(6):847-853.
  • Candia R, Ruiz A, Torres-Robles R, Chávez-Tapia N, Méndez-Sánchez N, Arrese M. Risk of non-alcoholic fatty liver disease in patients with psoriasis: A systematic review and meta-analysis. J Eur Acad Dermatol Venereol. 2015;29(4):656-662.
  • Mantovani A, Gisondi P, Lonardo A, Targher G. Relationship between non-alcoholic fatty liver disease and psoriasis: A novel hepato-dermal axis? Int J Mol Sci. 2016;17(2):217.
  • Torosian K, Lal E, Kavanaugh A, Loomba R, Ajmera V, Guma M. Psoriatic disease and non-alcoholic fatty liver disease shared pathogenesis review. Semin Arthritis Rheum. 2023;59:152165.
  • Riazi K, Azhari H, Charette JH, et al. The prevalence and incidence of NAFLD worldwide: A systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2022;7(9):851-861.
  • Mantovani A, Scorletti E, Mosca A, Alisi A, Byrne CD, Targher G. Complications, morbidity and mortality of nonalcoholic fatty liver disease. Metabolism. 2020;111S:154170.
  • Sumida Y, Nakajima A, Itoh Y. Limitations of liver biopsy and non-invasive diagnostic tests for the diagnosis of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. World J Gastroenterol. 2014;20(2):475- 485.
  • Jeon SK, Lee JM, Joo I, Park SJ. Quantitative ultrasound radiofrequency data analysis for the assessment of hepatic steatosis in nonalcoholic fatty liver disease using magnetic resonance imaging proton density fat fraction as the reference standard. Korean J Radiol. 2021;22(7):1077- 1086.
  • Caussy C, Reeder SB, Sirlin CB, Loomba R. Noninvasive, quantitative assessment of liver fat by MRI-PDFF as an endpoint in NASH Trials. Hepatology. 2018;68(2):763- 772.
  • Bannas P, Kramer H, Hernando D, et al. Quantitative magnetic resonance imaging of hepatic steatosis: Validation in ex vivo human livers. Hepatology. 2015;62(5):1444-1455.
  • Issa N, Poggio ED, Fatica RA, Patel R, Ruggieri PM, Heyka RJ. Nephrogenic systemic fibrosis and its association with gadolinium exposure during MRI. Cleve Clin J Med. 2008;75(2):95-97
  • Şendur HN, Cerit MN, Ibrahimkhanli N, Şendur AB, Özhan Oktar S. Interobserver variability in ultrasound- based liver fat quantification. J Ultrasound Med. 2023;42(4):833-841

HEPATOSTEATOZ DEĞERLENDİRMEDE ETKİN BİR ÖLÇEĞİN PSÖRİATİK ARTRİTLİ HASTALARDA KULLANIMI: DOKU ATENUASYON GÖRÜNTÜLEME

Year 2024, , 136 - 141, 20.08.2024
https://doi.org/10.24938/kutfd.1394513

Abstract

Amaç: Psöriatik artrit (PsA), çeşitli eklem tutulum türleri ile seyreden, tedavi yönetiminde zorluklarla karşılaşılan kronik bir destrüktif artropatidir. Alkol dışı karaciğer yağlanması (ADKY), psöriatik artritli hastalarda sık görülen bir komorbidite olup, bu çalışmanın amacı, PsA hastalarında ADKY'nin doku atenüasyon görüntüleme (TAI) skorunun sensitivitesini, bu skorun hastalık aktivitesi ve laboratuvar değerleri ile korelasyonunu değerlendirmektir.
Gereç ve Yöntemler: Çalışma, Ocak -Temmuz 2023 tarihleri arasında Gazi Üniversitesi Romatoloji ve Radyoloji kliniklerinin işbirliği ile gerçekleştirildi. “CLASsification for Psoriatic ARthritis (CASPAR)” kriterlerine göre tanı almış 25 PsA hastası dahil edildi. Hastaların demografik verileri, hastalık aktiviteleri ve laboratuvar değerleri kaydedildi. TAI skorları, ADKY olan ve olmayan gruplar arasında karşılaştırıldı.
Bulgular: TAI skorları, ADKY olan PsA hastalarında anlamlı olarak yüksek bulundu (p=0.006). GGT, ESR (eritrosit sedimentasyon hızı) ve hemoglobin düzeyleri ADKY olanlarda daha yüksek saptandı (p=0.002, 0.004 ve 0.019). TAI skoru, trigliserid, GGT ve ESR değerleri ile pozitif korelasyon gösterdi.
Sonuçlar: Çalışma, PsA hastalarında ADKY'nin değerlendirilmesinde TAI skorunun etkinliğini ortaya koymaktadır. Bu yöntem, invaziv olmayan ve kantitatif bir değerlendirme sağlayarak hastaların takibine katkıda bulunabilir. PsA hastalarında ADKY'nin erken tespiti, komplikasyonları önleme açısından önemlidir.

Ethical Statement

etik kurulu tarafından çalışmamız onaylanmış olup onay numarası: 591 dir

Supporting Institution

herhangi bir destek alınmamıştır

References

  • Brockbank J, Gladman D. Diagnosis and management of psoriatic arthritis. Drugs. 2002;62(17):2447-2457.
  • Gladman DD, Shuckett R, Russell ML, Thorne JC, Schachter RK. Psoriatic arthritis (PSA)--An analysis of 220 patients. Q J Med. 1987;62(238):127-141.
  • Gladman DD. Current concepts in psoriatic arthritis. Curr Opin Rheumatol. 2002;14(4):361-366.
  • Miele L, Vallone S, Cefalo C, et al. Prevalence, characteristics and severity of non-alcoholic fatty liver disease in patients with chronic plaque psoriasis. J Hepatol. 2009;51(4):778-786.
  • Diani M, Altomare G, Reali E. T Helper Cell Subsets in clinical manifestations of psoriasis. J Immunol Res. 2016;7692024.
  • Benham H, Norris P, Goodall J, et al. Th17 and Th22 cells in psoriatic arthritis and psoriasis. Arthritis Res Ther. 2013;15(5):R136.
  • Barr RG. Ultrasound of diffuse liver disease ıncluding elastography. Radiol Clin North Am. 2019;57(3):549-562.
  • Ferraioli G, Berzigotti A, Barr RG, et al. Quantification of liver fat content with ultrasound: A WFUMB position paper. Ultrasound Med Biol. 2021;47(10):2803-2820.
  • Şendur HN, Özdemir Kalkan D, Cerit MN, Kalkan G, Şendur AB, Özhan Oktar S. Hepatic fat quantification with novel ultrasound based techniques: A diagnostic performance study using magnetic resonance imaging proton density fat fraction as reference standard. Can Assoc Radiol J. 2023;74(2):362-369.
  • Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H; CASPAR Study Group. Classification criteria for psoriatic arthritis: Development of new criteria from a large international study. Arthritis Rheum. 2006;54(8):2665-2673.
  • Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new approach to defining disease status in ankylosing spondylitis: The Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol. 1994;21(12):2286-2291.
  • Fransen J, van Riel PL. The Disease Activity Score and the EULAR response criteria. Clin Exp Rheumatol. 2005;23(5 Suppl 39):S93-99.
  • Fredriksson T, Pettersson U. Severe psoriasis--oral therapy with a new retinoid. Dermatologica. 1978;157(4):238-244.
  • Griffiths CEM, Armstrong AW, Gudjonsson JE, Barker JNWN. Psoriasis. Lancet. 2021;397(10281):1301-1315.
  • Gladman DD, Antoni C, Mease P, Clegg DO, Nash P. Psoriatic arthritis: Epidemiology, clinical features, course, and outcome. Ann Rheum Dis. 2005;64 Suppl 2(Suppl 2):ii14-17.
  • Mease PJ, Gladman DD, Papp KA, et al. Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European/North American dermatology clinics. J Am Acad Dermatol. 2013;69(5):729-735.
  • Kalyoncu U, Bayindir Ö, Ferhat Öksüz M, et al. Psoriatic Arthritis Registry of Turkey Study Group. The Psoriatic Arthritis Registry of Turkey: Results of a multicentre registry on 1081 patients. Rheumatology (Oxford). 2017;56(2):279-286
  • Fransen J, van Riel PL. The disease activity Score and the EULAR response criteria. Clin Exp Rheumatol. 2005 Sep- Oct;23(5 Suppl 39):S93-99.
  • Gladman DD, Ang M, Su L, Tom BD, Schentag CT, Farewell VT. Cardiovascular morbidity in psoriatic arthritis. Ann Rheum Dis. 2009;68(7):1131-1135.
  • Jamnitski A, Symmons D, Peters MJ, Sattar N, McInnes I, Nurmohamed MT. Cardiovascular comorbidities in patients with psoriatic arthritis: A systematic review. Ann Rheum Dis. 2013;72(2):211-216.
  • Kaine J, Song X, Kim G, Hur P, Palmer JB. Higher ıncidence rates of comorbidities in patients with psoriatic arthritis compared with the general population using U.S. Administrative Claims Data. J Manag Care Spec Pharm. 2019;25(1):122-132.
  • Luken PC. Social identity in later life: a situational approach to understanding old age stigma. Int J Aging Hum Dev. 1987;25(3):177-193.
  • Bellinato F, Gisondi P, Mantovani A, Girolomoni G, Targher G. Risk of non-alcoholic fatty liver disease in patients with chronic plaque psoriasis: An updated systematic review and meta-analysis of observational studies. J Endocrinol Invest. 2022;45(7):1277-1288.
  • Haroon M, Rafiq Chaudhry AB, Fitzgerald O. Higher prevalence of metabolic syndrome in patients with psoriatic arthritis: A comparison with a control group of noninflammatory rheumatologic conditions. J Rheumatol. 2016;43(2):463-464.
  • Haroon M, Gallagher P, Heffernan E, FitzGerald O. High prevalence of metabolic syndrome and of insulin resistance in psoriatic arthritis is associated with the severity of underlying disease. J Rheumatol. 2014;41(7):1357-1365.
  • Pakchotanon R, Ye JY, Cook RJ, Chandran V, Gladman DD. Liver abnormalities in patients with psoriatic arthritis. J Rheumatol. 2020;47(6):847-853.
  • Candia R, Ruiz A, Torres-Robles R, Chávez-Tapia N, Méndez-Sánchez N, Arrese M. Risk of non-alcoholic fatty liver disease in patients with psoriasis: A systematic review and meta-analysis. J Eur Acad Dermatol Venereol. 2015;29(4):656-662.
  • Mantovani A, Gisondi P, Lonardo A, Targher G. Relationship between non-alcoholic fatty liver disease and psoriasis: A novel hepato-dermal axis? Int J Mol Sci. 2016;17(2):217.
  • Torosian K, Lal E, Kavanaugh A, Loomba R, Ajmera V, Guma M. Psoriatic disease and non-alcoholic fatty liver disease shared pathogenesis review. Semin Arthritis Rheum. 2023;59:152165.
  • Riazi K, Azhari H, Charette JH, et al. The prevalence and incidence of NAFLD worldwide: A systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2022;7(9):851-861.
  • Mantovani A, Scorletti E, Mosca A, Alisi A, Byrne CD, Targher G. Complications, morbidity and mortality of nonalcoholic fatty liver disease. Metabolism. 2020;111S:154170.
  • Sumida Y, Nakajima A, Itoh Y. Limitations of liver biopsy and non-invasive diagnostic tests for the diagnosis of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. World J Gastroenterol. 2014;20(2):475- 485.
  • Jeon SK, Lee JM, Joo I, Park SJ. Quantitative ultrasound radiofrequency data analysis for the assessment of hepatic steatosis in nonalcoholic fatty liver disease using magnetic resonance imaging proton density fat fraction as the reference standard. Korean J Radiol. 2021;22(7):1077- 1086.
  • Caussy C, Reeder SB, Sirlin CB, Loomba R. Noninvasive, quantitative assessment of liver fat by MRI-PDFF as an endpoint in NASH Trials. Hepatology. 2018;68(2):763- 772.
  • Bannas P, Kramer H, Hernando D, et al. Quantitative magnetic resonance imaging of hepatic steatosis: Validation in ex vivo human livers. Hepatology. 2015;62(5):1444-1455.
  • Issa N, Poggio ED, Fatica RA, Patel R, Ruggieri PM, Heyka RJ. Nephrogenic systemic fibrosis and its association with gadolinium exposure during MRI. Cleve Clin J Med. 2008;75(2):95-97
  • Şendur HN, Cerit MN, Ibrahimkhanli N, Şendur AB, Özhan Oktar S. Interobserver variability in ultrasound- based liver fat quantification. J Ultrasound Med. 2023;42(4):833-841
There are 37 citations in total.

Details

Primary Language Turkish
Subjects Health Services and Systems (Other)
Journal Section Özgün Araştırma
Authors

Derya Yıldırım 0000-0003-2771-7725

Ayça Tamer 0009-0007-0415-9931

Mahinur Cerit 0000-0003-2878-6052

Hamit Küçük 0000-0003-1206-4725

Halit Nahit Şendur 0000-0003-1690-2538

Publication Date August 20, 2024
Submission Date November 22, 2023
Acceptance Date April 16, 2024
Published in Issue Year 2024

Cite

APA Yıldırım, D., Tamer, A., Cerit, M., Küçük, H., et al. (2024). HEPATOSTEATOZ DEĞERLENDİRMEDE ETKİN BİR ÖLÇEĞİN PSÖRİATİK ARTRİTLİ HASTALARDA KULLANIMI: DOKU ATENUASYON GÖRÜNTÜLEME. The Journal of Kırıkkale University Faculty of Medicine, 26(2), 136-141. https://doi.org/10.24938/kutfd.1394513
AMA Yıldırım D, Tamer A, Cerit M, Küçük H, Şendur HN. HEPATOSTEATOZ DEĞERLENDİRMEDE ETKİN BİR ÖLÇEĞİN PSÖRİATİK ARTRİTLİ HASTALARDA KULLANIMI: DOKU ATENUASYON GÖRÜNTÜLEME. Kırıkkale Üni Tıp Derg. August 2024;26(2):136-141. doi:10.24938/kutfd.1394513
Chicago Yıldırım, Derya, Ayça Tamer, Mahinur Cerit, Hamit Küçük, and Halit Nahit Şendur. “HEPATOSTEATOZ DEĞERLENDİRMEDE ETKİN BİR ÖLÇEĞİN PSÖRİATİK ARTRİTLİ HASTALARDA KULLANIMI: DOKU ATENUASYON GÖRÜNTÜLEME”. The Journal of Kırıkkale University Faculty of Medicine 26, no. 2 (August 2024): 136-41. https://doi.org/10.24938/kutfd.1394513.
EndNote Yıldırım D, Tamer A, Cerit M, Küçük H, Şendur HN (August 1, 2024) HEPATOSTEATOZ DEĞERLENDİRMEDE ETKİN BİR ÖLÇEĞİN PSÖRİATİK ARTRİTLİ HASTALARDA KULLANIMI: DOKU ATENUASYON GÖRÜNTÜLEME. The Journal of Kırıkkale University Faculty of Medicine 26 2 136–141.
IEEE D. Yıldırım, A. Tamer, M. Cerit, H. Küçük, and H. N. Şendur, “HEPATOSTEATOZ DEĞERLENDİRMEDE ETKİN BİR ÖLÇEĞİN PSÖRİATİK ARTRİTLİ HASTALARDA KULLANIMI: DOKU ATENUASYON GÖRÜNTÜLEME”, Kırıkkale Üni Tıp Derg, vol. 26, no. 2, pp. 136–141, 2024, doi: 10.24938/kutfd.1394513.
ISNAD Yıldırım, Derya et al. “HEPATOSTEATOZ DEĞERLENDİRMEDE ETKİN BİR ÖLÇEĞİN PSÖRİATİK ARTRİTLİ HASTALARDA KULLANIMI: DOKU ATENUASYON GÖRÜNTÜLEME”. The Journal of Kırıkkale University Faculty of Medicine 26/2 (August 2024), 136-141. https://doi.org/10.24938/kutfd.1394513.
JAMA Yıldırım D, Tamer A, Cerit M, Küçük H, Şendur HN. HEPATOSTEATOZ DEĞERLENDİRMEDE ETKİN BİR ÖLÇEĞİN PSÖRİATİK ARTRİTLİ HASTALARDA KULLANIMI: DOKU ATENUASYON GÖRÜNTÜLEME. Kırıkkale Üni Tıp Derg. 2024;26:136–141.
MLA Yıldırım, Derya et al. “HEPATOSTEATOZ DEĞERLENDİRMEDE ETKİN BİR ÖLÇEĞİN PSÖRİATİK ARTRİTLİ HASTALARDA KULLANIMI: DOKU ATENUASYON GÖRÜNTÜLEME”. The Journal of Kırıkkale University Faculty of Medicine, vol. 26, no. 2, 2024, pp. 136-41, doi:10.24938/kutfd.1394513.
Vancouver Yıldırım D, Tamer A, Cerit M, Küçük H, Şendur HN. HEPATOSTEATOZ DEĞERLENDİRMEDE ETKİN BİR ÖLÇEĞİN PSÖRİATİK ARTRİTLİ HASTALARDA KULLANIMI: DOKU ATENUASYON GÖRÜNTÜLEME. Kırıkkale Üni Tıp Derg. 2024;26(2):136-41.

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