Tai Chi Intervention, Liver Disease Prevalence for People with OA | ACR Convergence

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Researchers explored the benefits of tai chi and prevalence of liver disease in patients with osteoarthritis.

Observing gut microbiota and liver disease outcomes for patients experiencing osteoarthritis (OA), researchers found that clinical tai chi can improve patients’ OA pain.1 A similar group of patients with OA exhibited a significantly high prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD), as well as liver fibrosis.2 Research data was extracted from posters presented at the American College of Rheumatology Convergence 2024.

“CDC estimates that 1 in 5 (or 53.2 million) US adults have some form of arthritis. While there are estimated to be more than 100 types of arthritis, OA is the most common form of arthritis, affecting 32.5 million US adults,” wrote the OA Action Alliance.3

Put It Into Practice

Incorporate these strategies into your pharmacy practice to improve patient outcomes.

  • Discuss how tai chi might positively influence the gut microbiota, which plays a role in overall health, including liver function.
  • Explain to patients that tai chi has shown promise in reducing OA pain.
  • Reinforce the significance of maintaining a healthy weight, as obesity is a risk factor for both OA and liver disease.

Along with OA, steatotic liver disease (SLD) impacts a large amount of the US population. Researchers predict both OA and SLD prevalence to increase in the future due to an aging population and its association with obesity.2 Furthermore, researchers are exploring alternative methods to treat OA pain; one being tai chi.

“Previous studies show that tai chi achieves clinical improvement for [OA] through multiple pathways. There is evidence for interaction of the gut microbiota with occurrence and severity of OA pain,” wrote authors of the poster.1 According to Harvard Health, tai chi is a low-impact and slow-motion exercise that involves body movements named after animals. Also known as meditation—or medication—in motion, tai chi originated as a martial art but has since evolved into a type of therapy.4

Both research posters were presented at ACR Convergence 2024. | image credit: PheelingsMedia / stock.adobe.com

Both research posters were presented at ACR Convergence 2024. | image credit: PheelingsMedia / stock.adobe.com

READ MORE: Advancements Needed in Treating, Identifying Drug-Induced Liver Injury

With previous research showing tai chi’s effectiveness in patients with OA, researchers wanted to explore how the digestive system affects OA outcomes. Citing further research about the digestive system’s link to OA, furthermore, they focused on the gut microbiota and the digestive health trends seen in patients with OA being treated with tai chi.

“There is evidence for interaction of the gut microbiota with occurrence and severity of OA pain. Behavioral responses to tai chi might modulate gut microbial composition and function through vagal modulation and the hypothalamic-pituitary-adrenal axis to influence the pathogenesis of OA pain,” wrote authors of the poster.1

Researchers included 73 adults (mean age, 66.5 years; 73.1% women) aged 55 or over in the study. Participants were assigned to receive either wellness education or tai chi sessions and asked to meet for remote sessions biweekly for 12 weeks. “The primary outcome was difference in gut microbiota composition and diversity measured via Bray-Curtis dissimilarity and change in relative abundance of the genus Streptococcus (previously associated with OA pain) at 12 weeks,” they continued.1

For the 67 participants that completed pre- and post-intervention, those in the tai chi group showed improved pain and function scores compared with those that received wellness education.

“This study confirms a benefit of tai chi on OA pain and function and a relationship of microbial composition on OA symptoms but this preliminary analysis does not support an effect of tai chi on the microbiome. More research is needed in this field,” concluded authors of the poster.1

With researchers further identifying a relationship between digestive health and OA, they then wanted to establish an understanding of various types of liver diseases and how often they are found in patients with OA. The 3 types of liver disease researchers observed were MASLD, MetALD (new disease entity defined as metabolic dysfunction in combination with moderate weekly alcohol intake), and alcohol-associated liver disease (ALD).2 A secondary outcome was liver fibrosis among patients with OA.

Results for MASLD and liver fibrosis prevalence among patients with OA were much more significant compared with alcohol-associated liver diseases. Indeed, researchers highlighted that “the age-adjusted prevalence of MASLD, MetALD, and ALD were 33.27%, 0.83%, and 0.67%, respectively,” showing a staggering difference between MASLD and MetALD or ALD. Furthermore, patients with both OA and MASLD were more likely to develop diabetes, dyslipidemia, and a BMI of over 30 kg/m2.

From therapies like glucagon-like peptide-1s (GLP-1s) to tai chi, a slew of research is being conducted to learn more about OA and the pain patients experience on a daily basis. Aiming to decrease the inflammation patients with liver disease and OA experience, more and more therapeutic options are being explored.

“There is high prevalence of MASLD and liver fibrosis among patients with OA and high correlation of both, with several systemic diseases such as obesity, diabetes, and cardiovascular disease. A comprehensive approach to early detection and treatment of SLD in OA patients with comorbidities is crucial for reducing potential adverse health outcomes. Future research should explore new ways to decrease the inflammatory state seen with SLD in this patient population,” concluded authors of the poster.2

For more coverage of ACR Convergence 2024, click here.

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References
1. Wang C, McAlindon T, Short M, Chung M, Chen Y, Tai A, Ward H. Remote-Delivered Tai Chi and Gut Microbiota in Osteoarthritis: A Randomized Mechanistic Trial [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). Accessed November 20, 2024. https://acrabstracts.org/abstract/remote-delivered-tai-chi-and-gut-microbiota-in-osteoarthritis-a-randomized-mechanistic-trial/
2. Vassilopoulos A, Vassilopoulos S, Kalligeros M, et al. Prevalence of steatotic liver disease and liver fibrosis among patients with osteoarthritis (OA) [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). Accessed November 20, 2024. https://acrabstracts.org/abstract/prevalence-of-steatotic-liver-disease-and-liver-fibrosis-among-patients-with-osteoarthritis-oa/
3. OA prevalence & burden: Osteoarthritis prevention and management in primary care. Osteoarthritis Action Alliance; 2024. Accessed November 21, 2024. https://oaaction.unc.edu/wp-content/uploads/sites/623/2024/05/OA-Prevalence-and-Burden-final-updated-5.30.24.pdf
4. The health benefits of tai chi. Harvard Health Publishing. Published May 24, 2022. Accessed November 21, 2024. https://www.health.harvard.edu/staying-healthy/the-health-benefits-of-tai-chi
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