Non‐alcoholic fatty liver disease fibrosis score in patients with psoriasis

Abstract

Patients with psoriasis should be screened for common causes of liver disease, including NAFLD and liver fibrosis.

Nonalcoholic fatty liver disease in patients with psoriasis: a consequence of systemic inflammatory burden?

“…Initial case reports documented psoriasis in three patients with NASH, a patient with NASH and comorbid type 2 diabetes and psoriasis, and a patient with psoriasis, increased insulin resistance markers, elevated liver enzymes and NASH . Thereafter, investigations into a possible link between psoriasis and NAFLD ensued, and in each controlled retrospective or prospective study, the prevalence of NAFLD was significantly higher in patients with psoriasis than in healthy or matched controls (17–66% vs. 8–35%, respectively) . Additionally, patients with psoriasis were at significantly increased risk for NAFLD than controls (odds ratio 2·15) in a systematic review and meta‐analysis of seven case–controlled studies, six of which assessed risk of NAFLD among individuals with and without psoriasis …”

“…Although both psoriasis and NAFLD are associated with metabolic conditions, such as MetS, insulin resistance and obesity, it was unclear whether psoriasis could be independently associated with NAFLD. Recently, two studies demonstrated that psoriasis was a significant predictor of liver disease, and in elderly patients, psoriasis was independently associated with a 70% increased likelihood for developing NAFLD . When patients with and without psoriasis were compared, NAFLD Fibrosis Scores (−1·57 vs. −3·10; P ≤ 0·0001), presence of steatosis (44·3% vs. 34·0%; P = 0·02) and presence of advanced liver fibrosis (8·1% vs. 3·6%; P = 0·05) were significantly higher in patients with psoriasis; drug exposure was not evaluated .…”

“…Recently, two studies demonstrated that psoriasis was a significant predictor of liver disease, and in elderly patients, psoriasis was independently associated with a 70% increased likelihood for developing NAFLD . When patients with and without psoriasis were compared, NAFLD Fibrosis Scores (−1·57 vs. −3·10; P ≤ 0·0001), presence of steatosis (44·3% vs. 34·0%; P = 0·02) and presence of advanced liver fibrosis (8·1% vs. 3·6%; P = 0·05) were significantly higher in patients with psoriasis; drug exposure was not evaluated . Furthermore, psoriasis is a significant predictor of NAFLD severity and the likelihood of having advanced NAFLD was increased by approximately 60% when psoriasis was present .…”

“…These steps are further intensified by the presence of psoriasis and accompanying inflammatory processes and altered TNF‐α: adiponectin ratio, which promotes liver disease progression . Thus, a vicious cycle of iterative liver damage continues, wherein risk of progression is increased when psoriasis, particularly severe psoriasis, is present . In turn, psoriasis severity may be worsened by reactive oxygen species, CRP, IL‐6 and other proinflammatory cytokines released from the damaged liver …”

High prevalence of non‐alcoholic fatty liver disease among hidradenitis suppurativa patients independent of classic metabolic risk factors

“…There is growing evidence that NAFLD is a multisystemic disease, affecting extra‐hepatic organs, and it has been associated with different disorders such as cardiovascular diseases, T2DM, chronic kidney disease, several endocrinopathies, osteoporosis and psoriasis . In this sense, the association between NAFLD and psoriasis has been well established . However, despite HS and psoriasis share a chronic systemic inflammatory state, the association between HS and NAFLD has not been previously described.…”