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

Abstract

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.