Predictive Performances of Blood-Count-Derived Inflammatory Markers for Liver Fibrosis Severity in Psoriasis Vulgaris

Abstract

Psoriasis is an immune-mediated, chronic disorder that significantly alters patients’ quality of life and predisposes them to a higher risk of comorbidities, including liver fibrosis. Various non-invasive tests (NITs) have been validated to assess liver fibrosis severity, while blood-count-derived inflammatory markers have been proven to be reliable in reflecting inflammatory status in psoriatic disease. The fibrosis-4 (FIB-4) index became part of the newest guideline for monitoring psoriasis patients undergoing systemic treatment. Patients with psoriasis vulgaris and fulfilling inclusion criteria were enrolled in this study, aiming to assess for the first time in the literature whether such inflammatory markers are useful in predicting liver fibrosis. Based on internationally validated FIB-4 index values, patients were divided into two study groups: a low risk of significant fibrosis (LR-SF) and a high risk of significant fibrosis (HR-SF). Patients from HR-SF were significantly older and had higher values of the monocyte-to-lymphocyte ratio (MLR) (p < 0.001), which further significantly correlated with fibrosis severity (p < 0.001). Platelet-to-lymphocyte ratio (PLR), systemic immune inflammation index (SII), platelet-to-white blood cell ratio (PWR), and aggregate index of systemic inflammations (AISI) significantly correlated negatively with liver fibrosis (p < 0.001). PWR proved to be the most reliable inflammatory predictor of fibrosis severity (AUC = 0.657). MLR, PWR, and AISI were independent inflammatory markers in multivariate analysis (p < 0.001), while the AST to platelet ratio index (APRI) and AST to ALT ratio (AAR) can be used as additional NITs for significant liver fibrosis (p < 0.001). In limited-resources settings, blood-count-derived inflammatory markers such as MLR, PWR, and AISI, respectively, and hepatic indexes APRI and AAR prove to be of particular help in predicting significant liver fibrosis.

Impact of Blood-Count-Derived Inflammatory Markers in Psoriatic Disease Progression

“…Additionally, these markers can be used as indicators of all-cause mortality [31] and cardiovascular disease [32]. We have recently shown their reliability in assessing liver fibrosis [33] in psoriasis. NLR and PLR decreased in a similar form to the C-reactive protein (CRP) in Japanese patients treated with all kinds of biologics [34], and can, therefore, be useful in assessing the response to systemic treatment.…”

Eosinophil-Count-Derived Inflammatory Markers and Psoriasis Severity: Exploring the Link

“…Previous studies have identified various blood-count-derived inflammatory markers to be associated with psoriasis. The most extensive studies, on neutrophil-to-lymphocyte ratio (NLR) and platelets-to-lymphocyte ratio (PLR), adequately reflect disease severity, treatment response [25], and various comorbidities associated with psoriasis, such as liver fibrosis [26], cardiovascular disease [27,28], or articular damage [29]. Even though several studies focusing on peripheral leucocytes and various subsets are available, as presented earlier, no published reports refer to eosinophil-count-derived inflammatory markers and psoriasis.…”

Systemic immune-inflammation index mediates the association between metabolic dysfunction-associated fatty liver disease and sub-clinical carotid atherosclerosis: a mediation analysis

“…As expected, the positive correlation of increased SII quartiles and Ln (SII) with the risk of MAFLD and SCAS persisted. Additionally, SII has been validated as a diagnostic index for various inflammatory digestive diseases ( 34 , 35 ) and coronary artery disease ( 36 ). Similarly, this study also found that SII exhibited a favorable diagnostic value for MAFLD and SCAS.…”