S1732 Intersecting Paths of Osteoarthritis and Metabolic-Associated Steatotic Liver Disease

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Introduction: Metabolic-associated steatotic liver disease (MASLD) is characterized by hepatic fat accumulation in individuals with metabolic risk factors such as obesity, insulin resistance, dyslipidemia, and hypertension. Osteoarthritis (OA) is the predominant form of arthritis and involves progressive joint cartilage degeneration. A recent national study reported a significant association between the 2 diseases. MASLD and OA share metabolic etiologies. Whether both conditions are related still needs elucidating. Methods: Patients with a diagnosis of OA and patients with a diagnosis of MASLD were identified utilizing the National Inpatient Sample (NIS) data from 2016 to 2020. Primary outcome was the association of the 2 diseases in the general population tested by multivariable logistic regression analysis. Secondary outcomes were the differences in the characteristics and outcomes between a cohort of MASLD with OA and a control cohort of MASLD without OA. Unweighted data from NIS were multiplied with appropriate discharge and hospital-level weights to represent the population across the USA. Results: OA was significantly associated with MASLD (Odds Ratio=1.226; P=0.00; Confidence Interval 1.21-1.24) with adjusting for sex, age, race, Charlson Comorbidity Index, obesity, smoking, location and hospital characteristics (Table 1). Out of a total of 2,982,525 with MASLD, 10.78% of those patients had osteoarthritis. Patients with MASLD that had OA were older in age than MASLD who did not have OA (63 years vs 54 years), had higher percentage of females (64% vs 52%), had a higher component of White ethnicity (77% vs 66%) and had a higher percentage of Medicare insured patients (58% vs 38%). Interestingly, MASLD with OA were noted to have a lower mortality rate, shorter length of stay, and fewer total charges. All the aforementioned results were statistically significant with a P< 0.0001. The rest of the results of the comparison between the 2 cohorts are in the attached table. Conclusion: This study establishes a positive association between OA and MASLD. Shared risk factors such as obesity, dyslipidemia, and insulin resistance, alongside chronic low-grade inflammation, likely contribute to their co-occurrence through shared metabolic and inflammatory pathways. The findings in this study highlight the importance of understanding the relationship between OA and MASLD, and warrant further investigation into the causal pathways, therapeutic interventions, and comprehensive management approaches to improve outcomes for affected individuals. Table 1. - Baseline characteristics, hospital characteristics, comorbidities and outcomes Characteristic MASLD with OA MASLD without OA P-value Age (years) 63.32 54.61 0.0000 Female (%) 63.54 52.58 0.0000 Race (%) 0.0000 White 75.99 66.82 Black 9.09 9.80 Hispanic 10.39 16.76 Asian/Pacific Islander 1.60 2.36 Native American 0.69 1.02 Other 2.24 3.24 Charlson Comorbidity Index (%) 0.0000 0 1.81 1.53 1 21.06 29.20 2 22.60 21.66 ≥3 54.52 47.60 Median household income national quartile (%) 0.0172 1 (lowest) 30.09 29.44 2 27.24 27.11 3 24.29 24.42 4 (highest) 18.38 19.03 Insurance (%) 0.0000 Medicare 57.80 37.93 Medicaid 12.02 21.46 Private 28.03 33.82 Self-pay 2.15 6.80 Hospital region (%) 0.0000 Northeast 15.20 16.71 Midwest 26.55 21.47 South 39.70 39.21 West 18.55 22.61 Hospital bed size (%) 0.1995 Small 20.68 20.11 Medium 28.18 28.12 Large 51.13 51.76 Hospital location (%) 0.0000 Urban 92.18 93.64 Rural 7.82 6.36 Hospital teaching status (%) 0.0000 Non-teaching 28.64 25.93 Teaching 71.36 74.07 Congestive Heart Failure (%) 18.56 15.74 0.0000 Cardiac Arrhythmias (%) 21.19 18.45 0.0000 Valvular Disease (%) 7.57 5.39 0.0000 Pulmonary Circulation Disorders (%) 5.68 5.21 0.0000 Peripheral Vascular Disorders (%) 8.23 5.71 0.0000 Hypertension, Uncomplicated (%) 51.58 41.42 0.0000 Paralysis (%) 1.04 1.21 0.0013 Other Neurological Disorders (%) 9.28 11.20 0.0000 Chronic Pulmonary Disease (%) 32.07 22.24 0.0000 Diabetes, Uncomplicated (%) 20.20 18.22 0.0000 Diabetes, Complicated (%) 30.43 27.86 0.0000 Hypothyroidism (%) 20.98 14.35 0.0000 Renal Failure (%) 19.20 15.93 0.0000 Liver Disease (%) 8.69 6.65 0.0000 Peptic Ulcer Disease (%) 1.75 1.76 0.9246 AIDS/HIV (%) 0.14 0.37 0.0000 Lymphoma (%) 0.93 0.96 0.5345 Metastatic Cancer (%) 1.97 2.25 0.0002 Solid Tumor without Metastasis (%) 5.18 5.17 0.9162 Rheumatoid Arthritis (%) 6.59 3.51 0.0000 Coagulopathy (%) 13.72 18.25 0.0000 Obesity (%) 48.58 36.76 0.0000 Weight Loss (%) 5.74 8.32 0.0000 Deficiency Anemia (%) 6.80 7.29 0.0002 Alcohol Abuse (%) 8.74 19.07 0.0000 Drug Abuse (%) 4.51 7.08 0.0000 Psychoses (%) 1.34 1.79 0.0000 Depression (%) 27.03 18.51 0.0000 Hypertension, Complicated (%) 26.56 20.84 0.0000 AMI (Acute Myocardial Infarction) (%) 8.00 6.86 0.0000 CEVD (Cerebrovascular Disease) (%) 4.47 3.69 0.0000 Dementia (%) 3.46 2.31 0.0000 COPD (Chronic Obstructive Pulmonary Disease) (%) 32.07 22.24 0.0000 Rheumatoid Disease (%) 5.75 3.00 0.0000 Mild Liver Disease (%) 81.51 79.47 0.0000 HP/PAPL (Hemiplegia or Paraplegia) (%) 1.04 1.21 0.0013 Moderate/Severe Liver Disease (%) 9.60 13.63 0.0000 Outcomes Died during hospitalization (%) 1.33 2.14 0.0000 Length of stay (days) 4.54 5.30 0.0000 Total charges ($) 61,056 67,602 0.0000

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