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August 22, 2026Clinical and Experimental MedicineOpen Access

Hepatic steatosis and its associated factors in patients with rheumatoid arthritis based on quantitative assessment by ultrasound-derived fat fraction

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Authors

YLYuanxu LiNanjing University of Chinese MedicineZZZhixuan ZhangNanjing University of Chinese MedicineYWYantian WangSichuan University

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Implication

Cross-sectional study finds high hepatic steatosis rates in rheumatoid arthritis, indicating metabolic and drug links.

Key Points

  • To determine the prevalence of hepatic steatosis in rheumatoid arthritis patients and evaluate its associations with cumulative methotrexate exposure, metabolic markers, and inflammatory burden using ultrasound-derived fat fraction.
  • Single-center cross-sectional study enrolling 118 patients with rheumatoid arthritis.
  • Hepatic fat was quantitatively evaluated with ultrasound-derived fat fraction (UDFF), defining hepatic steatosis as UDFF ≥ 6%.
  • Multivariate logistic and linear regression, ROC analysis, and Firth penalized logistic regression evaluated associations with clinical markers, cumulative methotrexate dose, and CRP.
  • Hepatic steatosis was present in 49.2% (58/118) of patients with rheumatoid arthritis.
  • Fully adjusted logistic regression revealed positive associations with older age (OR = 1.09, 95% CI: 1.02–1.17, P = 0.014), higher BMI (OR = 1.64, 95% CI: 1.32–2.14, P < 0.001), higher TyG index (OR = 3.33, 95% CI: 1.07–12.00, P = 0.047), and cumulative methotrexate dose (per 100 mg: OR = 1.09, 95% CI: 1.01–1.18, P = 0.034), while CRP was negatively associated (per 5 mg/L: OR = 0.88, 95% CI: 0.79–0.98, P = 0.023).
  • Patients with cumulative methotrexate > 456 mg and CRP ≤ 8 mg/L had significantly elevated odds of steatosis compared to those with low exposure and high CRP (adjusted OR = 14.70, 95% CI: 3.33–86.40, P < 0.001).

Cite This Study

Li et al. (2026) studied this question.

synapsesocial.com/papers/6a895f87ca7ade938187e3cchttps://doi.org/10.1007/s10238-026-02281-6
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Also Consider

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