Saint Louis University School of Medicine St. Louis, MO
Kaila A. Fennell, BS, Maya Mahmoud, MD, Kamran Qureshi, MD Saint Louis University School of Medicine, St. Louis, MO
Introduction: Methotrexate (MTX) can be used to treat a variety of medical conditions. The adverse effects of methotrexate include liver injury. Metabolic syndrome (MS) is a known risk factors for metabolic dysfunction-associated steatotic liver disease (MASLD), but the relationship between metabolic syndrome and MTX-associated liver injury remains unclear. This study aims to investigate the impact of metabolic syndrome on severity of MTX associated liver disease identified by fibroscan (VCTE).
Methods: Patients with MTX-associated liver disease were identified in our liver clinic from May 2007 to June 2024. Charts were reviewed for baseline characteristics, presence of metabolic syndrome, and VCTE results. Metabolic syndrome was defined as three or more of the following criteria: BMI ≥ 30, elevated triglycerides or treatment for elevated triglycerides, decreased HDL, elevated blood pressure or treatment for elevated blood pressure, and elevated blood sugar or treatment for elevated blood sugars. VCTE results, including liver stiffness measurements (LSM) and controlled attenuation parameter (CAP), were collected and compared between groups.
Results: 59 patients with a mean age of 62 years (range 20-83), including 41 females (69%) were identified. Median BMI was 33.5 kg/m2 (range 18.6-50.3). In patients with metabolic syndrome (N=32), median LSM and CAP were 12.2(6.9) and 303(54.5), respectively. In patients without metabolic syndrome (n=25), median LSM and CAP were 7.2(7.7) and 220(74.9). The results of the Mann-Whitney test showed higher LSM (kPa) measurements (U=531.5, p=0.034) and higher CAP (dB/m) measurements (U=659.0, p< .001) are associated with the presence of metabolic syndrome.
Discussion: There is a positive association between metabolic syndrome and MTX-associated livery injury as described in LSM and CAP from VCTE. Increased LSM and CAP on liver VCTE can be a result of underlying obesity/MASLD, direct effect of MTX or both.
Figure: The association between median LSM (A) and CAP (B) with metabolic syndrome in patients with MTX-induced liver injury. LSM: liver stiffness measurement, CAP: controlled attenuation parameter.
Disclosures:
Kaila Fennell indicated no relevant financial relationships.
Maya Mahmoud indicated no relevant financial relationships.
Kaila A. Fennell, BS, Maya Mahmoud, MD, Kamran Qureshi, MD. P2890 - Impact of Metabolic Syndrome on Liver Fibrosis and Steatosis in Patients With Methotrexate-Associated Liver Injury: A Retrospective Study, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
