Romatoid Artritli Hastalarda Alkol Dışı Yağlı Karaciğer Hastalığı Sıklığı

Öz

Amaç: Romatoid Artrit anılı hastalarda alkol dışı yağlı karaciğer sıklığını araştırmayı amaçladık. Gereç ve Yöntem: Ocak 2018 ile Aralık 2019 yılları arasında fizik tedavi kliniğince takip edilen RA hastaları çalışmaya dahil edildi. Bu hastaların dosyaları taranarak demografik verileri, biyokimyasal, radyolojik verileri kaydedildi. Kontrol grubu olarak dispepsi nedeniyle gastroenteroloji polikliniğine başvuran hastalar alındı. Bulgular: Çalışmaya 59 RA hastası 59 kontrol grubu hastası dahil edildi. Kontrol ve hasta grubunun yaş ortalaması ve cinsiyet dağılımı açısında fark yoktu. Cinsiyet dağılımı hasta grubunda kadın erkek dağılımı 51:8, kontrol grubunda ise 50:9 idi (p=0,79). Yaş ortalaması hasta grubunda 52±10 yıl, kontrol grubunda ise 48±12 yıl idi (p=0,23). Alkol dışı yağlı karaciğer sıklığı Romatoid Artrit grubunda 16 (27.1%), kontrol grubunda ise 21(35.6%) idi (p: 0.32). Sonuç: Bu çalışmada beklenilenin aksine RA’da kontrol grubunda göre NAFLD sıklığının artmadığı görülmüştür.

Anahtar Kelimeler

• Romatoid Artrit
• Alkol Dışı Yağlı Karaciğer Hastalığı
• Kronik Karaciğer Hastalığı

Frequency of Non-Alcoholic Fatty Liver Disease in Patients with Rheumatoid Arthritis

Öz

Objective: To determine the frequency of non-alcoholic fatty liver disease in patients with rheumatoid arthritis. Methods: Patients with rheumatoid arthritis who were followed up by the physical therapy clinic between January 2018 and December 2019 were included in this study. The demographic and biochemical data of these patients were recorded by scanning their files. The presence of non-alcoholic fatty liver was investigated by scanning ultrasonography and computed tomography documents. Patients who applied to the gastroenterology outpatient clinic due to dyspepsia were included as the control group. Results: Fifty-nine rheumatoid arthritis patients and 59 control group patients were included in the study. There was no difference between the control and patient groups in terms of mean age and gender distribution. The gender distribution was 51: 8 in the patient group and 50: 9 in the control group (p = 0.79). The mean age was 52 ± 10 years in the patient group and 48 ± 12 years in the control group (p = 0.23). The frequency of non-alcoholic fatty liver disease was 16 (27.1%) in patients with rheumatoid arthritis and 21 (35.6%) in the control group (p: 0.32). Conclusion: Nonalcoholic fatty liver disease is not more frequent in patients with rheumatoid arthritis.

Anahtar Kelimeler

• Rheumatoid Arthritis
• Non-Alcoholic Fatty Liver Disease
• Chronic Liver Disease
• Romatoid Artrit
• Alkol Dışı Yağlı Karaciğer Hastalığı
• Kronik Karaciğer Hastalığı

Kaynakça

1. 1. Kelly’s text book of rheumatology 9th ed. St Louis: WB Saunders, 2012:1132-1133.
2. 2. Carlo S, Maria SM, Eric G. Liver involvement in subjects with rheumatic disease. Arthritis Res Ther. 201113:226. doi: 10.1186/ar3319
3. 3. Ruderman M, Crawford M, Maier A, Liu J, Gravallese M, Weinblatt E. Histologic liver abnormalities in an autopsy series of patients with rheumatoid arthritis. Br J Rheumatol. 1997;36: 210-213.
4. 4. Younossi Z, Tacke F, Arrese M, Sharma BC, Mostafa I, Bugianesi E, et al. Global Perspectives on Non-alcoholic Fatty Liver Disease and Non-alcoholic Steatohepatitis. Hepatology. 2018.
5. 5. Rau R, Pfenninger K, Boni A. Proceedings: liver function tests and liver biopsies in patients with rheumatoid arthritis. Ann Rheum Dis 1975; 34:198–9.
6. 6. Ursini F. TNF-alpha and insulin-resistance: metabolic effects of in vivo therapeutic blockade. Reumatismo 2009; 61:254–9
7. 7. Giacomelli R, Ruscitti P, Alvaro S, Ciccia F, Liakouli V, Di Benedetto P et al. IL-1beta at the crossroad between rheumatoid arthritis and type 2 diabetes: may we kill two birds with one stone? Expert Rev Clin Immunol 2016; 12:849–55.
8. 8. Ursini F, Naty S, Russo E, Grembiale RD. Abatacept in psoriatic arthritis: case report and short review. J Pharmacol Pharmacother 2013;4: 29–32

9. 9. Khov N, Sharma A, Riley TR. Bedside ultrasound in the diagnosis of nonalcoholic fatty liver disease. World J Gastroenterol. 2014;20(22):6821-6825.
10. 10. WaganA, Bhutoo A, Khan D, Raheem A. Fatty liver in Pakistani cohort with rheumatoid arthritis. Pak J Med Sci. 2020;36(4):723-728
11. 11. Mori S, Arima N, Ito M, Fujiyama S, Kamo Y, Ueki Y. Non-alcoholic steatohepatitis-like pattern in liver biopsy of rheumatoid arthritis patients with persistent transaminitis during low- dose methotrexate treatment. PLoS ONE 2018;13(8): e0203084
12. 12. Sakthiswary R, Chan GY, Koh ET, Leong KP, Thong BY. Mehtotreaxte associated non alchoholic fatty liver disease with transaminitis in rheumatoid arthritis. Scientific World J. 2014;2014: 823763.
13. 13. Ruderman M, Crawford M, Maier A, Liu J, Gravallese M, Weinblatt E. Histologic liver abnormalities in an autopsy series of patients with rheumatoid arthritis. Br J Rheumatol. 1997;36: 210-213.
14. 14. Emilie Q, Jean S, Hubert M, Pierre M. Rare incidence of methotrexate-specific lesions in liver biopsy of patients with arthritis and elevated liver enzymes, Arthritis Res Ther. 2010;12:143.
15. 15. Ursini F, Russo E, Mauro D, Abenavoli L, Ammerata G, Serrao A , et al. Complement C3 and fatty liver disease in Rheumatoid arthritis patients: a cross-sectional studyEur J Clin Invest 2017; 47 (10): 728–735
16. 16. Linda F, Avegail F, Cristina A, Christina P, Terri C, Andreas R. Nonalcoholic fatty liver disease: a potential consequence of tumor necrosis factor-inhibitor therapy. Eur J Gastroenterol Hepatol. 2015;27(10):1154-1160.
17. 17. EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. Journal Hepatology 2016;64(6):1388-402
18. 18. Naga Chalasani, Zobair Younossi, Joel E. Lavine, Michael Charlton, Kenneth Cusi, Mary Rinella, etal. The Diagnosis and Management of Nonalcoholic Fatty Liver Disease: Practice Guidance from the American Association for the Study of Liver Diseases. Hepatology 2018;67(1) ;328-57