AB0250 OSTEOPOROSIS, VERTEBRAL FRACTURES AND NON-ALCOHOLIC FATTY LIVER DISEASE IN RHEUMATOID ARTHRITIS: ARE THEY ASSOCIATED?

Background:Non-alcoholic fatty liver disease (NAFLD) is a frequent finding in rheumatoid arthritis (RA). It has been advanced that NAFLD and vertebral fractures (VF) are associated in healthy men recently(1).Objectives:The aim of this study was to evaluate NAFLD association with BMD and VF in RA population.Methods:Cross-sectional study was made at our rheumatology department, patients with RA have been assessed for NAFLD with ultrasonography and osteoporosis (hip and lumber BMD) with DXA device. Patients with secondary liver disease (viral, alcoholic) were excluded. Data about osteoporosis risk factors, clinical features and laboratory tests (liver enzymes, lipid profile, hemoglobin, ferritin, etc) were collected. Anterior vertebral fractures (VF) were assessed by lateral spine radiographs. Comparison of patients with and without NAFLD was done by SPSS.20. Multiple regressions were made to explain osteoporosis and VF with models including NAFLD and other risk factors. Significance was defined by p under 0.05.Results:We have included 172 RA patients, mean age was 55.4±11.9 years. Ninety per cent were females. Their average BMI was 26.8±5.47. Hypertension was diagnosed in 23.8% and 16.3% had diabetes. Forty per cent (40.1) had osteoporosis, 27.3% (47) had NAFLD. RA patients with NAFLD were older (p=0.04), obese (p=0.003), frequently associated to diabetes (p=0.02), Sjogren’s disease (p=0.001), higher total cholesterol (p=0.02) and gamma-glutamyl transferase (GGT) (p=0.002). Comparison tests did not reveal any associations with fractures, BMD or osteoporosis. In multiple regression models, patients with NAFLD and altered liver enzymes were associated to VF (p=0.04, OR=4.7[1.05-21.69] but not to BMD when adjusted on age (p=0.02), BMI (p=0.02), diabetes, menopause and Sjogren’s disease.Conclusion:NAFLD was frequent among our RA patients and was associated to VF prevalence in this study but not to BMD.References:[1]Mantovani A, Dauriz M, Gatti D, Viapiana O, Zoppini G, Lippi G, et al. Systematic review with meta-analysis: non-alcoholic fatty liver disease is associated with a history of osteoporotic fractures but not with low bone mineral density. Aliment Pharmacol Ther. 2019 Feb;49(4):375–88.Disclosure of Interests:None declared

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Lean non-alcoholic fatty liver disease (Lean-NAFLD): characteristics and risk factors from a community cohort follow up study

10.26226/morressier.57c5383fd462b80296c9b9f3 ◽

2016 ◽

Author(s):

Madunil Niriella

Keyword(s):

Risk Factors ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Follow Up Study ◽

Lean Nafld ◽

Alcoholic Fatty Liver Disease

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Faculty Opinions recommendation of Risk of Cirrhosis and Hepatocellular Cancer in Patients with Non-Alcoholic Fatty Liver Disease and Normal Liver Enzymes.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.737325078.793571058 ◽

2020 ◽

Author(s):

Philip Rosenthal

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Liver Enzymes ◽

Hepatocellular Cancer ◽

Normal Liver ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

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Non-alcoholic fatty liver disease in polycystic ovary syndrome women

Scientific Reports ◽

10.1038/s41598-021-86697-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Young Bin Won ◽

Seok Kyo Seo ◽

Bo Hyon Yun ◽

SiHyun Cho ◽

Young Sik Choi ◽

...

Keyword(s):

Risk Factors ◽

Liver Disease ◽

Fatty Liver ◽

Liver Enzyme ◽

Fatty Liver Disease ◽

Polycystic Ovary ◽

Insulin Level ◽

University Hospital ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

AbstractTo evaluate risk factors leading to non-alcoholic fatty liver disease (NAFLD) occurrence in polycystic ovarian syndrome (PCOS) women. A retrospective cohort study of a total of 586 women diagnosed with PCOS aged 13–35 years at the gynecology department at a university hospital was done to evaluate PCOS phenotype, metabolic syndrome (MetS) diagnosis, body composition, insulin sensitivity, sex hormones, lipid profile, liver function, and transient elastography (TE). In PCOS women with NAFLD compared to those without, MetS diagnosis (Hazard ratio [HR] 5.6, 95% Confidence interval [CI] 2.2–14.4, p < 0.01) and hyperandrogenism (HA) (HR 4.4, 95% CI 1.4–13.4, p = 0.01) were risk factors significantly associated with subsequent NAFLD occurrence, whereas 2-h insulin level in 75 g glucose tolerance test (GTT) (HR 1.2, 95% CI 0.5–2.5, p = 0.70) and body mass index (BMI) > 25 kg/m2 (HR 2.2, 95% CI 0.6–8.0, p = 0.24) was not. Among NAFLD patients who underwent TE, a higher number of MetS components indicated a worse degree of fibrosis and steatosis. MetS diagnosis and HA at PCOS diagnosis were risk factors associated with NAFLD, while 2-h insulin level in 75 g GTT and obesity were not. Although elevated aspartate aminotransferase levels were significant for NAFLD risk, liver enzyme elevations may not be present until late liver damage. Further prospective studies of PCOS women with MetS or HA are warranted to determine whether patients without liver enzyme elevations should undergo preemptive liver examinations.

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Implementation of a care bundle improves the management of patients with non-alcoholic fatty liver disease

Frontline Gastroenterology ◽

10.1136/flgastro-2020-101480 ◽

2021 ◽

pp. flgastro-2020-101480

Author(s):

Laura Jane Neilson ◽

Louise Macdougall ◽

Phey Shen Lee ◽

Timothy Hardy ◽

David Beaton ◽

...

Keyword(s):

Risk Factors ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Metabolic Risk Factors ◽

Care Bundle ◽

Metabolic Risk ◽

Lifestyle Advice ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

BackgroundNon-alcoholic fatty liver disease (NAFLD) is common and is associated with liver-related and cardiovascular-related morbidity. Our aims were: (1) to review the current management of patients with NAFLD attending hospital clinics in North East England (NEE) and assess the variability in care; (2) develop a NAFLD ‘care bundle’ to standardise care; (3) to assess the impact of implementation of the NAFLD care bundle.MethodsA retrospective review was conducted to determine baseline management of patients with NAFLD attending seven hospitals in NEE. A care bundle for the management of NAFLD was developed including important recommendations from international guidelines. Impact of implementation of the bundle was evaluated prospectively in a single centre.ResultsBaseline management was assessed in 147 patients attending gastroenterology, hepatology and a specialist NAFLD clinic. Overall, there was significant variability in the lifestyle advice given and management of metabolic risk factors, with patients attending an NAFLD clinic significantly more likely to achieve >10% body weight loss and have metabolic risk factors addressed. Following introduction of the NAFLD bundle 50 patients were evaluated. Use of the bundle was associated with significantly better documentation and implementation of most aspects of patient management including management of metabolic risk factors, documented lifestyle advice and provision of NAFLD-specific patient advice booklets.ConclusionThe introduction of an outpatient ‘care bundle’ led to significant improvements in the assessment and management of patients with NAFLD in the NEE and could help improve and standardise care if used more widely.

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11. Risk factors for development of diabetes mellitus in non-alcoholic fatty liver disease (NAFLD) patients

Journal of Clinical and Experimental Hepatology ◽

10.1016/j.jceh.2018.06.341 ◽

2018 ◽

Vol 8 ◽

pp. S39-S40

Author(s):

Shivaram Prasad Singh ◽

Saroj Kanta Sahu ◽

Prasanta Kumar Parida ◽

Sambit Kumar Behera ◽

Suryakanta Parida ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

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Genetic and Life Style Risk Factors for Recurrent Non-alcoholic Fatty Liver Disease Following Liver Transplantation

Frontiers in Nutrition ◽

10.3389/fnut.2021.787430 ◽

2022 ◽

Vol 8 ◽

Author(s):

Speranta Iacob ◽

Susanne Beckebaum ◽

Razvan Iacob ◽

Cristian Gheorghe ◽

Vito Cicinnati ◽

...

Keyword(s):

Risk Factors ◽

Liver Transplantation ◽

Liver Disease ◽

Fatty Liver ◽

Life Style ◽

Fatty Liver Disease ◽

Alcoholic Fatty Liver ◽

Recurrent Nash ◽

Alcoholic Fatty Liver Disease

Recurrent or de novo non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH) following liver transplantation (LT) is a frequent event being increasingly recognized over the last decade, but the influence of recurrent NASH on graft and patient outcomes is not yet established. Taking into consideration the long term survival of liver transplanted patients and long term complications with associated morbidity and mortality, it is important to define and minimize risk factors for recurrent NAFLD/NASH. Metabolic syndrome, obesity, dyslipidemia, diabetes mellitus are life style risk factors that can be potentially modified by various interventions and thus, decrease the risk of recurrent NAFLD/NASH. On the other hand, genetic factors like recipient and/or donor PNPLA3, TM6SF2, GCKR, MBOAT7 or ADIPOQ gene polymorphisms proved to be risk factors for recurrent NASH. Personalized interventions to influence the different metabolic disorders occurring after LT in order to minimize the risks, as well as genetic screening of donors and recipients should be performed pre-LT in order to achieve diagnosis and treatment as early as possible.

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