Ursini F, et al. – In this assessment, the specialists examined the performance of complement fraction C3 for prediction of non–alcoholic fatty liver disease (NAFLD) in rheumatoid arthritis (RA) patients. Accumulated evidence supported the potential role of complement C3 as a surrogate biomarker of NAFLD in RA patients.

Methods

• The specialists included consecutive RA patients, in this study.
• According to predefined ultrasonographic (US) criteria, NAFLD was diagnosed.
• The hepatic steatosis index (HSI) was calculated, for comparison.

Results

• Out of 164 consecutive RA patients, 41 (25%) were diagnosed with NAFLD.
• Outcomes revealed that the NAFLD group had a significant lower proportion of females (p = 0.04), higher BMI (p < 0.0001), C–reactive protein (p = 0.04), complement C3 (p = 0.001) and HSI (p = 0.003).
• In a logistic regression model, only male sex (OR 2.65, 95% CI: 1.08 – 6.50, p = 0.03), increasing BMI (OR 1.22, 95% CI: 1.02 – 1.46, p = 0.03) and complement C3 (OR 5.05, 95% CI: 1.06 – 23.93, p = 0.04) were associated with higher likelihood of being diagnosed with NAFLD.
• ROC curves were made for BMI, complement C3 and their combination for prediction of having NAFLD.
• The best cut–off for BMI was 28.5 kg/m² and yielded a sensitivity of 66% and a specificity of 71%; the best cut–off for complement C3 was 1.23 g/l and yielded a sensitivity of 76% and a specificity of 64% for classification of NAFLD cases.