Complement C3 and fatty liver disease in Rheumatoid arthritis patients: a cross-sectional study

Abstract

Our results provide preliminary evidence for a potential role of complement C3 as a surrogate biomarker of NAFLD in RA patients.

Response to the letter to the editor by Shadmani et al

“…Dear Editor-in-Chief, We read with great interest the letter by Shadmani et al regarding our recently published article investigating the correlation between complement C3 and nonalcoholic fatty liver disease (NAFLD) in rheumatoid arthritis (RA) patients. 1 The authors raised some technical issues about the statistical methodology of our work. We truly appreciated the precious and highly qualified contribution-given the leading expertise of the authors in the field of biostatistics and epidemiology-and largely agree with them that the crosssectional design of our study may significantly limit the ability of our results to support definitive conclusions regarding the direction of the relationship between C3 and NAFLD.…”

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Response to the letter to the editor by Shadmani et alDear Editor-in-Chief, We read with great interest the letter by Shadmani et al regarding our recently published article investigating the correlation between complement C3 and nonalcoholic fatty liver disease (NAFLD) in rheumatoid arthritis (RA) patients. 1 The authors raised some technical issues about the statistical methodology of our work. We truly appreciated the precious and highly qualified contribution-given the leading expertise of the authors in the field of biostatistics and epidemiology-and largely agree with them that the crosssectional design of our study may significantly limit the ability of our results to support definitive conclusions regarding the direction of the relationship between C3 and NAFLD.However, we feel the need to clarify that the main aim of our manuscript was not that of confirming a direct, unimpeachable, unidirectional causal correlation between complement C3 and the future development of NAFLD, but rather to provide a hypothesis-generating basis for further, adequately powered longitudinal studies aiming at investigating in details the processes linking complement system to metabolic disturbances in RA patients, as already suggested by other studies published by our group.

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Alternative Approaches to Ameliorate Nonalcoholic Fatty Liver Disease: Phyllanthus niruri Clinicopathological Significance; A review

“…The potential role of complement fraction C3 as a biomarker of NAFLD in the general population has been indicated by recent data. Complement system activation has been shown in liver biopsies from patients with NAFLD compared to healthy control [28].…”

Comment on: Complement C3 and fatty liver disease in Rheumatoid arthritis patients: A cross‐sectional study

“…Finally, this study concludes that the complement C3 (OR 5.05, 95% CI: 1.06-23.93, P = .04), synergistically with BMI, can predict the presence of NAFLD with good sensitivity and specificity. 1 However, although this research was valuable and the results are interesting, there are some methodological issues which should be referred to them:…”

“…Dear Editor, We studied the paper entitled "Complement C3 and fatty liver disease in Rheumatoid arthritis patients: a cross-sectional study" written by Francesco Ursini et al, 1 which was published in European journal of clinical investigation in October 2017. The aim of the study was to evaluate the performance of C3 for prediction of NAFLD in RA patients.…”