Methotrexate-associated nonalcoholic fatty liver disease with transaminitis in rheumatoid arthritis

Sakthiswary Rajalingham, Grace Yin Lai Chan, Ee Tzun Koh, Khai Pang Leong, Bernard Yu Hor Thong

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background. The aim of this study was to determine the risk factors of MTX-associated nonalcoholic fatty liver disease (NAFLD) with transaminitis in a cohort of rheumatoid arthritis (RA) patients from Singapore. Methods. Patients who developed ultrasound proven NAFLD with transaminitis while on MTX therapy were identified. The demographic and clinical characteristics of the above patients (cases) were compiled and compared with age- and gender-matched controls who were RA patients on long standing MTX therapy without any episode of transaminitis. Results. Among the 978 patients who had received MTX, the prevalence of MTX-associated NAFLD was 4.7% (46 patients). Compared to the controls, the cases had significantly higher mean cumulative dose of MTX (4.03 ± 2.25 g versus 10.04 ± 9.94 g, P ≤ 0.05), weekly dose of MTX (11.3 ± 4.8 mg versus 13.1 ± 4.4 mg weekly, P = 0.033), and fasting blood glucose (P = 0.029). Following multivariate regression analysis, only cumulative dose of MTX remained significant (P = 0.015). Among the cases, the cumulative dose of MTX was found to have a significant positive correlation with the alanine transaminase (ALT) level (P < 0.05, standardised beta coefficient 0.512). Conclusion. The cumulative dose of MTX was the only independent predictor of MTX-associated NAFLD with transaminitis.

Original languageEnglish
Article number823763
JournalScientific World Journal
Volume2014
DOIs
Publication statusPublished - 2014

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Methotrexate
Liver
Rheumatoid Arthritis
Alanine Transaminase
fasting
Regression analysis
Blood Glucose
risk factor
Ultrasonics
Singapore
regression analysis
gender
glucose
blood
Non-alcoholic Fatty Liver Disease
dose
Fasting
Multivariate Analysis
Regression Analysis
Demography

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Environmental Science(all)
  • Medicine(all)

Cite this

Methotrexate-associated nonalcoholic fatty liver disease with transaminitis in rheumatoid arthritis. / Rajalingham, Sakthiswary; Chan, Grace Yin Lai; Koh, Ee Tzun; Leong, Khai Pang; Thong, Bernard Yu Hor.

In: Scientific World Journal, Vol. 2014, 823763, 2014.

Research output: Contribution to journalArticle

Rajalingham, Sakthiswary ; Chan, Grace Yin Lai ; Koh, Ee Tzun ; Leong, Khai Pang ; Thong, Bernard Yu Hor. / Methotrexate-associated nonalcoholic fatty liver disease with transaminitis in rheumatoid arthritis. In: Scientific World Journal. 2014 ; Vol. 2014.
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abstract = "Background. The aim of this study was to determine the risk factors of MTX-associated nonalcoholic fatty liver disease (NAFLD) with transaminitis in a cohort of rheumatoid arthritis (RA) patients from Singapore. Methods. Patients who developed ultrasound proven NAFLD with transaminitis while on MTX therapy were identified. The demographic and clinical characteristics of the above patients (cases) were compiled and compared with age- and gender-matched controls who were RA patients on long standing MTX therapy without any episode of transaminitis. Results. Among the 978 patients who had received MTX, the prevalence of MTX-associated NAFLD was 4.7{\%} (46 patients). Compared to the controls, the cases had significantly higher mean cumulative dose of MTX (4.03 ± 2.25 g versus 10.04 ± 9.94 g, P ≤ 0.05), weekly dose of MTX (11.3 ± 4.8 mg versus 13.1 ± 4.4 mg weekly, P = 0.033), and fasting blood glucose (P = 0.029). Following multivariate regression analysis, only cumulative dose of MTX remained significant (P = 0.015). Among the cases, the cumulative dose of MTX was found to have a significant positive correlation with the alanine transaminase (ALT) level (P < 0.05, standardised beta coefficient 0.512). Conclusion. The cumulative dose of MTX was the only independent predictor of MTX-associated NAFLD with transaminitis.",
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