Association of Nonalcoholic Hepatic Fibrosis with Body Composition in Female and Male Psoriasis Patients

Abstract

Psoriasis has been associated with increased frequency of hepatic diseases. Psoriasis severity, obesity, insulin resistance, aspartate aminotransferase level, platelet count, and alcohol use are significant predictors for advanced fibrosis in psoriasis patients. Although psoriasis patients also present body composition changes (e.g., higher overall body fat, visceral fat and sarcopenia), and these have recently been reported as risk factors for hepatic fibrosis, to date, body composition has not been prospectively investigated in psoriasis in the context of liver fibrosis. In this study anthropometric assessment (body weight and body mass index (BMI)), body composition analysis (body fat%, visceral fat scores and muscle mass%), and liver stiffness measurements (using transient elastography [TE]) were done in 52 psoriasis patients undergoing methotrexate therapy. Fourteen patients (26.9%) had advanced (F3–F4) liver fibrosis. There was no correlation between the patients’ liver stiffness values and the cumulative MTX doses. On the other hand, patients with higher BMI values, total body fat% and visceral fat scores were significantly more likely to present with higher hepatic stiffness values. BMI was a significant predictor of hepatic fibrosis in both genders. In males, body fat% (R = 0.578, p = 0.002) and, especially, visceral fat scores (R = 0.716, p < 0.001) had statistically significant correlation with stiffness scores, while in females only visceral fat scores were statistically significant predictors of the liver stiffness values (R = 0.452, p = 0.023), and body fat% was not (R = 0.187, p = 0.382). Our results suggest that anthropometric data should be assessed differently in female and male psoriasis patients when evaluating liver fibrosis risk.

Vibration-controlled transient elastography for non-invasive screening of liver fibrosis and steatosis in Turkish patients with psoriasis: A cross-sectional study

“…[19] In this study, we determined BMI to be the sole predictor of LSM, a non-invasive indicator of fibrosis, among our psoriatic patients. Our current findings are in line with those of a prior investigation by Brunner et al, [20] which examined a sample of 52 Hungarian patients. Their findings indicated that patients with psoriasis and higher BMI values were more likely to exhibit elevated hepatic stiffness values, which is in agreement with the results of our study.…”

“…Their findings indicated that patients with psoriasis and higher BMI values were more likely to exhibit elevated hepatic stiffness values, which is in agreement with the results of our study. [ 20 ] Additionally, we confirmed that methotrexate treatment does not represent an independent risk factor for liver fibrosis in patients with psoriasis, [ 20 ] as its predictive value is clearly overshadowed by the influence of BMI. However, we were unable to identify independent predictors of steatosis in our study group.…”

Liver fibrosis prevalence and risk factors in patients with psoriasis: A systematic review and meta-analysis

“…In contrast, a recent systematic review of eight observational studies involving 429 psoriasis patients reported no clear association between cumulative MTX dose and liver fibrosis (69). Additionally, many observational studies (27,33,46,48,52,66,86) did not find any association between MTX cumulative dose and the risk of liver fibrosis. Lynch et al discovered an association between MTX cumulative dose and abnormal FibroTest results, but not with TE (48).…”

Niosomal Curcumin Suppresses IL17/IL23 Immunopathogenic Axis in Skin Lesions of Psoriatic Patients: A Pilot Randomized Controlled Trial

“…Corticosteroids not only have several side effects, but also do not prompt satisfactory clinical impacts [ 29 ]. Medication alternatives to corticosteroids include methotrexate, cyclosporine, and small molecule biologicals such as adalimumab (Humira), a TNF-alpha-blocking antibody, and brodalumab (Siliq), a human antibody against interleukins (IL12/23 inhibitors, IL17 inhibitors, IL23 inhibitors) [ 30 , 31 ].…”