Association of Liver Steatosis, Specific Organokines, and Cardiovascular Risk Factors in Patients with Rheumatoid Arthritis

Overview

This study investigates the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) in rheumatoid arthritis (RA) patients and evaluates the diagnostic performance of liver fat indices and organokines. Findings indicate that MASLD is present in approximately one-third of RA patients, with specific indices showing associations with cardiovascular risk factors.

Background

Metabolic dysfunction-associated steatotic liver disease (MASLD) is frequently observed in patients with rheumatoid arthritis (RA), often remaining undiagnosed due to its asymptomatic nature. Understanding the relationship between liver steatosis and cardiovascular risk in RA patients is important.

Data Highlights

Key Findings

• Approximately one-third of RA patients were found to have MASLD.
• The fatty liver index (FLI) and fatty acid binding protein 4 (FABP4) showed the best diagnostic discrimination for MASLD.
• FLI was positively associated with cardiovascular risk scores and left ventricular diastolic dysfunction parameters.
• The neutrophil-to-lymphocyte ratio (NLR) was significantly associated with an increased risk of MASLD.
• FLI and HSI demonstrated moderate-to-good discrimination for ultrasound-defined MASLD.
• Further investigation into FABP4 and fibroblast growth factor 21 (FGF21) as adjunctive biomarkers for MASLD is warranted.

Clinical Implications

The study highlights the importance of using non-invasive liver fat indices for early detection of MASLD in RA patients. Clinicians should consider the associations between liver steatosis and cardiovascular risk factors when managing RA patients to improve overall patient outcomes.

Conclusion

The study presents findings on the diagnostic utility of liver fat indices and their relationship with cardiovascular risk in RA patients.

Related Resources & Content

1. Clinical Rheumatology, 2025 -- Cardiovascular Risk Factors and Metabolic Dysfunction-Related Steatotic Liver Disease in Patients with Rheumatoid Arthritis
2. The Journal of Clinical Endocrinology & Metabolism, 2025 -- Additional Predictive Value of Blood-Based Liver Fibrosis Indicators in Assessing Cardiovascular Risk
3. Clinical Rheumatology, 2016 -- Early Phase Hormonal, Metabolic Peptide, and Nutrient Profiles in Rheumatoid Arthritis: The Role of Free Fatty Acids in Heightened Cardiovascular Risk During Initial Disease Stages
4. EASL–EASD–EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD): Executive Summary - PMC, 2024
5. Rheumatology International, 2025 -- Rheumatoid arthritis is independently associated with metabolic Dysfunction-Associated steatotic liver disease: evidence from the paracelsus 10,000 Population-Based cohort study
6. Clinical Rheumatology — Association of Sodium and Potassium Intake with Urinary Sodium-to-Potassium Ratio in Rheumatoid Arthritis: Links to Cardiovascular Dysfunction and Disease-Related Factors
7. EASL–EASD–EASO Clinical Practice Guidelines on MASLD
8. Rheumatoid arthritis is independently associated with metabolic Dysfunction-Associated steatotic liver disease: evidence from the paracelsus 10,000 Population-Based cohort study | Rheumatology International | Springer Nature Link
9. Neutrophil-to-Lymphocyte Ratio and Fibroblast Growth Factor 21: Their Role in Early Cardiovascular Involvement in Rheumatoid Arthritis | MDPI