Mahapatro Abinash, Jafari Maryam, Jeanty Herby, Sahu Satabdi, Eslampanah Fatemeh, Amouzadeh-Lichahi Mohammad, Mirchandani Mohit, Raghuma Nakka, Patel Dhruvan, Mohanty Elan, Patel Kishan, Pasandipour Reyhaneh, Hashemi Seyyed Mohammad, Amini-Salehi Ehsan
Hi-Tech Medical College and Hospital, Rourkela, Odisha, India.
Student Research Committee, School of Medicine, Anzali International Campus, Guilan University of Medical Sciences, Rasht, Iran.
Medicine (Baltimore). 2025 Aug 8;104(32):e43641. doi: 10.1097/MD.0000000000043641.
Rheumatoid arthritis (RA) is a chronic autoimmune disorder associated with various comorbidities, including nonalcoholic fatty liver disease (NAFLD). The prevalence of NAFLD in RA patients remains inconsistently reported, necessitating a comprehensive meta-analysis to estimate its true prevalence. This study aimed to assess the prevalence of NAFLD in patients with RA by synthesizing data from multiple studies.
A systematic search was performed across PubMed, Scopus, and Web of Science for studies published up to January 2025. Eligible studies that reported on the prevalence of NAFLD in RA patients were included. A random-effects model was applied, and sensitivity analyses were conducted to test the robustness of the findings. Statistical analyses were performed using Comprehensive Meta-Analysis Software (CMA) version 4.
The pooled prevalence of NAFLD/nonalcoholic steatohepatitis (NASH) in RA patients was found to be 22.8% (95% CI = 7.8%-50.8%) with substantial heterogeneity (I² = 99.52%). The prediction interval for the prevalence of NAFLD/NASH ranged from 1% to 99%. Subgroup analysis showed varying prevalence rates based on diagnostic modalities: 33.3% for FibroScan, 43.9% for liver biopsy, and 30.5% for ultrasonography.
The prevalence of NAFLD is remarkable in RA patients, with varying rates depending on diagnostic methods. The substantial heterogeneity observed across studies, reflected in the wide range of the prediction interval, underscores the need for further studies to provide a more precise estimate. Given the notable prevalence of NAFLD/NASH in RA patients, clinicians are suggested to consider this issue by implementing regular liver screening as a valuable part of RA patient care. More studies are essential to offer a clearer and more consistent understanding of NAFLD/NASH in this population.
类风湿性关节炎（RA）是一种慢性自身免疫性疾病，与多种合并症相关，包括非酒精性脂肪性肝病（NAFLD）。RA患者中NAFLD的患病率报道不一，因此有必要进行全面的荟萃分析来估计其真实患病率。本研究旨在通过综合多项研究的数据来评估RA患者中NAFLD的患病率。
在PubMed、Scopus和Web of Science上进行系统检索，查找截至2025年1月发表的研究。纳入报告RA患者中NAFLD患病率的合格研究。应用随机效应模型，并进行敏感性分析以检验研究结果的稳健性。使用综合荟萃分析软件（CMA）版本4进行统计分析。
发现RA患者中NAFLD/非酒精性脂肪性肝炎（NASH）的合并患病率为22.8%（95%CI = 7.8%-50.8%），存在显著异质性（I² = 99.52%）。NAFLD/NASH患病率的预测区间为1%至99%。亚组分析显示，基于诊断方式的患病率有所不同：FibroScan为33.3%，肝活检为43.9%，超声检查为30.5%。
RA患者中NAFLD的患病率较高，且因诊断方法而异。各研究中观察到的显著异质性，反映在预测区间范围较宽，这突出表明需要进一步研究以提供更精确的估计。鉴于RA患者中NAFLD/NASH的患病率较高，建议临床医生通过定期进行肝脏筛查来考虑这一问题，将其作为RA患者护理的重要组成部分。需要更多研究以更清晰、一致地了解该人群中的NAFLD/NASH情况。
