Individuals with NALFD more than twice as likely to have osteoarthritis, study finds

"Individuals with NALFD were more than twice as likely to have osteoarthritis, even after adjusting for various factors (OR = 2.05)," the researchers reported.

"The correlation persisted across subgroups of age & metabolic syndrome, but importantly, the association was more pronounced in non-obese individuals, females and those without heightened C-reactive protein levels."

Previous studies have suggested that low-grade inflammation and metabolic derangements may at least be involved in the occurrence of osteoarthritis and NAFLD, implying that these two diseases have similar causative factors. However, few studies have explored the correlation between NAFLD and OA. Hence, Ting Li, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China, and colleagues investigated the association between NAFLD and OA in US adults.

For this purpose, the researchers performed a cross-sectional study on participants in the 2017–2018 National Health and Nutrition Examination Survey (NHANES) cycle. The diagnosis of osteoarthritis was based on self-reported data. NALFD was defined by the vibration-controlled transient elastography.

To explore the relationship and verify the stability of the conclusions, the research team performed logistic regression models and stratified analyses. They also performed propensity score matching (PSM) and sensitivity analysis using multiple imputations for missing data.

The study included 2622 participants [47.8% males] with a mean age of 48.1 years old, containing 317 OA patients and 1140 NAFLD patients. Based on the study, the researchers reported the following findings:

• A logistic regression indicated a significant association between NAFLD and OA without adjustment [odds ratio (OR) = 2.05]. The association remained stable after adjustment for covariates (OR = 1.72).
• Sensitivity analysis of missing data with multiple interpolations and PSM found similar results.
• A significant and consistent association of NAFLD with OA was still observed in each subgroup stratified by age and metabolic syndrome (MetS).
• Stratified by obesity, sex, and sensitivity c-reactive protein (hs-CRP) category, a statistically significant association was only shown in females, those without obesity, and those without hyper hs-CRP.
• The results illustrated that the relationship between NAFLD and OA was stable in all subgroups and had no interaction.

Using large-scale cross-sectional data from NHANES, the study clarified the relationship between NAFLD and OA. Compared to NALFD patients, those without showed a lower likelihood of OA.

"Given the current pandemic of NAFLD and OA, clinicians should screen for NAFLD in arthritis patients and intervene early, the research team concluded.

Reference:

Lu, Y., Zhang, J., Li, H. et al. Association of non-alcoholic fatty liver disease with self-reported osteoarthritis among the US adults. Arthritis Res Ther 26, 40 (2024). https://doi.org/10.1186/s13075-024-03272-2