Background: Rheumatoid arthritis (RA) promotes disruption of the lipid profile and leads to quantitative and qualitative abnormalities of lipoproteins. The causality link of certain medications used for RA treatment has been the focus of several studies, which have demonstrated the neutral or beneficial effect of methotrexate on lipid parameters, in contrast to the exacerbating role of glucocorticoids.

Objectives: The aim of our study is to assess parameters of lipid metabolism and screen for hepatic steatosis using the HSI score in patients with rheumatoid arthritis treated with methotrexate.

Methods: Retrospective descriptive and cross-sectional study including patients with rheumatoid arthritis (RA) according to the ACR/EULAR 2010 criteria treated with methotrexate alone. Data on lipid profile, transaminase levels, and body mass index (BMI) were collected. Hepatic steatosis was screened using the HSI score: HSI = 8 × (ALT/AST) + BMI + 2 (if type 2 diabetes) + 2 (if female).

Results: We identified 69 patients. The average age was 53 years, with a clear female predominance at 91.3%. The average duration of rheumatoid arthritis was 7.74 years. The average duration of methotrexate treatment was 3.97 years.

Dyslipidemia was found in 33 patients, with hypertriglyceridemia in 14 patients, hypercholesterolemia in 13 patients, and mixed dyslipidemia in 6 patients.

The HSI score was calculated for 60 patients, representing 86.9%. A score <30 was found in 37 patients, a score between 30 and 36 in 7 patients, and a score >36 in 25 patients, or 36.2%. A statistically significant correlation was found between the HSI score and the type of dyslipidemia (p=0.006, r=2).

Conclusion: Dyslipidemia was present in almost half of the cases, and hepatic steatosis was found in one-third of our patients with rheumatoid arthritis, exclusively under methotrexate treatment. The correlation between the HSI score and the lipid profile was significant.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: None declared.