Correlation between Cumulative Methotrexate Dose, Metabolic Syndrome and Hepatic Fibrosis Detected by FibroScan in Rheumatoid Arthritis Patients
<i>Background and Objectives</i>: Methotrexate (MTX) is routinely prescribed for rheumatoid arthritis (RA) patients, but high cumulative doses may lead to hepatic fibrosis. Additionally, a high proportion of RA patients suffer from metabolic syndrome, which also increases the risk of hep...
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| Format: | Article |
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MDPI AG
2023-05-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/6/1029 |
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| author | Ratchaya Lertnawapan Soonthorn Chonprasertsuk Sith Siramolpiwat Kanon Jatuworapruk |
| author_facet | Ratchaya Lertnawapan Soonthorn Chonprasertsuk Sith Siramolpiwat Kanon Jatuworapruk |
| author_sort | Ratchaya Lertnawapan |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Methotrexate (MTX) is routinely prescribed for rheumatoid arthritis (RA) patients, but high cumulative doses may lead to hepatic fibrosis. Additionally, a high proportion of RA patients suffer from metabolic syndrome, which also increases the risk of hepatic fibrosis. This cross-sectional study aimed to explore the association between a cumulative MTX dose, metabolic syndrome, and hepatic fibrosis in patients diagnosed with RA. <i>Materials and Methods</i>: RA patients undergoing treatment with MTX were examined using transient elastography (TE). All patients, regardless of having hepatic fibrosis, were compared to identify the risk factors. <i>Results</i>: Two hundred and ninety-five rheumatoid arthritis patients were examined using FibroScan. One hundred and seven patients (36.27%) were found to have hepatic fibrosis (TE > 7 kPa). After multivariate analysis, only BMI (OR = 14.73; 95% CI 2.90–74.79; <i>p</i> = 0.001), insulin resistance (OR = 312.07; 95% CI 6.19–15732.13; <i>p</i> = 0.04), and cumulative MTX dosage (OR 1.03; 95% CI 1.01–1.10; <i>p</i> = 0.002) were associated with hepatic fibrosis. <i>Conclusions</i>: While the cumulative MTX dose and metabolic syndrome are both the risk factors of hepatic fibrosis, metabolic syndrome, including a high BMI and insulin resistance, poses a greater risk. Therefore, MTX-prescribed RA patients with metabolic syndrome factors should be attentively monitored for signs of liver fibrosis. |
| first_indexed | 2024-03-11T02:11:01Z |
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| id | doaj.art-0e2a589f85824f5aa8956727b67fff29 |
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| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-11T02:11:01Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-0e2a589f85824f5aa8956727b67fff292023-11-18T11:30:26ZengMDPI AGMedicina1010-660X1648-91442023-05-01596102910.3390/medicina59061029Correlation between Cumulative Methotrexate Dose, Metabolic Syndrome and Hepatic Fibrosis Detected by FibroScan in Rheumatoid Arthritis PatientsRatchaya Lertnawapan0Soonthorn Chonprasertsuk1Sith Siramolpiwat2Kanon Jatuworapruk3Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani 12120, ThailandDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani 12120, ThailandDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani 12120, ThailandDivision of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani 12120, Thailand<i>Background and Objectives</i>: Methotrexate (MTX) is routinely prescribed for rheumatoid arthritis (RA) patients, but high cumulative doses may lead to hepatic fibrosis. Additionally, a high proportion of RA patients suffer from metabolic syndrome, which also increases the risk of hepatic fibrosis. This cross-sectional study aimed to explore the association between a cumulative MTX dose, metabolic syndrome, and hepatic fibrosis in patients diagnosed with RA. <i>Materials and Methods</i>: RA patients undergoing treatment with MTX were examined using transient elastography (TE). All patients, regardless of having hepatic fibrosis, were compared to identify the risk factors. <i>Results</i>: Two hundred and ninety-five rheumatoid arthritis patients were examined using FibroScan. One hundred and seven patients (36.27%) were found to have hepatic fibrosis (TE > 7 kPa). After multivariate analysis, only BMI (OR = 14.73; 95% CI 2.90–74.79; <i>p</i> = 0.001), insulin resistance (OR = 312.07; 95% CI 6.19–15732.13; <i>p</i> = 0.04), and cumulative MTX dosage (OR 1.03; 95% CI 1.01–1.10; <i>p</i> = 0.002) were associated with hepatic fibrosis. <i>Conclusions</i>: While the cumulative MTX dose and metabolic syndrome are both the risk factors of hepatic fibrosis, metabolic syndrome, including a high BMI and insulin resistance, poses a greater risk. Therefore, MTX-prescribed RA patients with metabolic syndrome factors should be attentively monitored for signs of liver fibrosis.https://www.mdpi.com/1648-9144/59/6/1029rheumatoid arthritismethotrexateDMARDshepatic fibrosismetabolic syndrome |
| spellingShingle | Ratchaya Lertnawapan Soonthorn Chonprasertsuk Sith Siramolpiwat Kanon Jatuworapruk Correlation between Cumulative Methotrexate Dose, Metabolic Syndrome and Hepatic Fibrosis Detected by FibroScan in Rheumatoid Arthritis Patients Medicina rheumatoid arthritis methotrexate DMARDs hepatic fibrosis metabolic syndrome |
| title | Correlation between Cumulative Methotrexate Dose, Metabolic Syndrome and Hepatic Fibrosis Detected by FibroScan in Rheumatoid Arthritis Patients |
| title_full | Correlation between Cumulative Methotrexate Dose, Metabolic Syndrome and Hepatic Fibrosis Detected by FibroScan in Rheumatoid Arthritis Patients |
| title_fullStr | Correlation between Cumulative Methotrexate Dose, Metabolic Syndrome and Hepatic Fibrosis Detected by FibroScan in Rheumatoid Arthritis Patients |
| title_full_unstemmed | Correlation between Cumulative Methotrexate Dose, Metabolic Syndrome and Hepatic Fibrosis Detected by FibroScan in Rheumatoid Arthritis Patients |
| title_short | Correlation between Cumulative Methotrexate Dose, Metabolic Syndrome and Hepatic Fibrosis Detected by FibroScan in Rheumatoid Arthritis Patients |
| title_sort | correlation between cumulative methotrexate dose metabolic syndrome and hepatic fibrosis detected by fibroscan in rheumatoid arthritis patients |
| topic | rheumatoid arthritis methotrexate DMARDs hepatic fibrosis metabolic syndrome |
| url | https://www.mdpi.com/1648-9144/59/6/1029 |
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