January 09, 2014
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Elderly patients with psoriasis more likely to develop NAFLD

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Elderly patients with psoriasis were 70% more likely to have nonalcoholic fatty liver disease than patients without psoriasis when adjusted for confounding risk factors, according to recent study results.

Researchers in the Netherlands studied 2,292 patients (mean age, 76.2 years; 58.6% women; mean BMI, 27.4 ± 4.2 kg/m2) who were part of a large, prospective population-based cohort study of Rotterdam residents aged 55 years or older. One hundred eighteen patients (5.1%) were diagnosed with psoriasis, and ultrasonography was used to identify nonalcoholic fatty liver disease (NAFLD). Adjustments were made for demographics, lifestyle characteristics and laboratory findings, and psoriasis associated with NAFLD was assessed through multivariable logistic regression model.

Patients with psoriasis had a 46.2% prevalence of NAFLD compared with 33.3% of the remaining 2,174 patients (controls; P=.005). Psoriasis and NAFLD were significantly associated and remained so after adjusting for excessive alcohol use (more than 14 drinks weekly), pack-years (years of smoking multiplied by average number of packs smoked daily), smoking status, presence of metabolic syndrome and alanine aminotransferase (OR=1.7; 95% CI, 1.13-2.58).

Patients with psoriasis were significantly more likely to have a BMI greater than 30 kg/m2 and an increased waist circumference compared with controls. The psoriasis patients also were more likely to be current smokers and to meet metabolic syndrome criteria (14.9% vs. 8.2%, P=.01; 62.2% vs. 52.2%, P=.05, respectively).

“Psoriasis seems to be independently associated with NAFLD,” the researchers concluded. “The increased prevalence of NAFLD in participants with psoriasis should alert physicians to consider possible chronic hepatic involvement before administering therapies with potentially liver toxicity.”

Disclosure: Researcher Tamar Nijsten, MD, PhD, serves as speaker, consultant and investigator for Abbvie, Janssen, Pfizer, Galderma, Celgene and Leo Pharma.