Fibroscan detection of fatty liver and liver fibrosis in patients with systemic lupus erythematosus

Abstract

Objective Although liver dysfunction is not considered the main organ involvement in Systemic Lupus Erythematosus (SLE), the frequency of liver dysfunction or abnormal liver enzyme values may be observed in 50–60% of patients. The aim of this study was to assess fatty liver and liver fibrosis in SLE patients using Fibroscan as well as determine associated factors such as immunosuppressive medications. Methods Sixty SLE patients and 30 healthy controls were included. Patients with HBV, HCV or cirrhosis, malignancy, cardiac disease, or patients on dialysis were excluded. All participants underwent Fibroscan measurements. Results The prevalence of fatty liver disease was similar between SLE patients and healthy controls (21.7 vs 26.7%, p = .597). Liver fibrosis was also similar between the two groups (26.7 vs 10.0%, p = .069). Since the majority of SLE patients were female, we performed a subgroup analysis in female patients ( n = 51) and controls ( n = 25). Fatty liver disease was similar between female SLE patients and controls (23.5 vs 24.0%, p = .964). However, liver fibrosis in female patients with SLE was increased compared to female controls (29.4 vs 4.0%, p = .011) and was associated with age (Exp (B) 95% CI: 1.083 (1.006–1.166), p = .034) and low-dose cumulative glucocorticoid use (Exp (B) 95% CI: 14.116 (1.213–164.210), p = .034). Conclusion The prevalence of fatty liver was similar between SLE patients and controls, while liver fibrosis was increased in the female patient group as compared to controls. Furthermore, liver fibrosis was associated with age and low dose cumulative glucocorticoid use. Interestingly, fatty liver did not precede liver fibrosis in the majority of cases, contrary to what is observed in the general population. Larger studies are needed to confirm our findings and determine whether immunosuppressive use has any impact on the development of liver fibrosis in SLE patients.

A cross sectional study assessing steatotic liver disease in patients with systemic lupus erythematosus

“…This, coupled with the younger age of our SLE patients, could partially explain the low prevalence of SLD. Our results are in line with the 23% prevalence reported by Yetginoglu et al in 60 patients with SLE 11 . Of note, in that study, the CAP cutoff point that was used to define steatosis was 238 dB/m rather than the more strongly recommended 275 dB/m, so it is possible that the prevalence in their study could www.nature.com/scientificreports/ even had been overestimated.…”

“…Regarding factors associated with SLD that we found in our study, it is not surprising that metabolic factors such as BMI, waist circumference, and glucose levels were associated with SLD. This is similar to what Yetginoglu et al found in their study 11 , and also to what Zamani et al found in the meta-analysis on rheumatoid arthritis mentioned above, where BMI, rather than methotrexate, was associated with SLD 7 . In contrast, similar to what Yetginoglu et al reported in their study, steroid use was not found to be associated with SLD 11 .…”

“…This is similar to what Yetginoglu et al found in their study 11 , and also to what Zamani et al found in the meta-analysis on rheumatoid arthritis mentioned above, where BMI, rather than methotrexate, was associated with SLD 7 . In contrast, similar to what Yetginoglu et al reported in their study, steroid use was not found to be associated with SLD 11 . It is worth emphasizing that even though patients with SLE traditionally have a higher prevalence of metabolic comorbidity (i.e.…”

“…In recent years, the most common finding in patients with SLE who undergo liver biopsy has been SLD. In contrast, a previous study of 60 patients with SLE reported a frequency of SLD in line with that of the general population 11 . Therefore, due to the implications of having SLD, this study aimed to assess whether SLE is associated with SLD and to determine which factors are associated with SLD and with significant fibrosis in these patients.…”

Prevalence of hepatic steatosis and fibrosis in apparently healthy airline pilots: a transient elastography study

“…[8,16] TE has proven to be an efficient, non-invasive, and consistent method for assessing liver steatosis and fibrosis across various high-risk groups. [17][18][19][20] This is, to our knowledge, the first study that specifically examines the prevalence of TE-confirmed hepatic steatosis and fibrosis in male APs. Our findings show that around 25% of the pilots, who appeared healthy, exhibited steatosis, while approximately 6% had F2 fibrosis or worse.…”