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Psoriasis severity affects severity of nonalcoholic fatty liver disease

Prospective study data presented at the European Academy of Dermatology and Venereology Congress demonstrated that psoriasis severity is associated with more severe hepatic damage among patients with both psoriasis and nonalcoholic fatty liver disease. Specifically, an increase in PASI score by one was associated with an increase in elastography of, on average, 0.26 kPa.

“Previous research has already established a link between psoriasis and NAFLD. This is one of the first studies to assess the relationship between the severity of psoriasis with the severity of NAFLD,” study author Daniel Nieto, MD, department of dermatology at La Paz Hospital in Madrid, said in a press release. “In this context, increasing awareness and the continued assessment of the severity of NAFLD in patients with psoriasis by primary care physicians, specialists, health policy makers and patients should be prioritized to help manage both conditions.”

The study included 64 patients with severe psoriasis and nonalcoholic fatty liver disease (NAFLD) who were evaluated by the hospital’s gastroenterology department between September 2017 and September 2018. Mean age of the patients was 53.4 years, and 64.1% were men. The highest historic Psoriasis Area and Severity Index (PASI) score was 11.2.

Researchers defined mild NAFLD as fibrosis less than stage F3, FIB4 less than 1.3 or elastography less than 7.1 kPa in patients who did not undergo biopsy. Severe disease was defined as fibrosis stage F3 or greater, FIB4 greater than 2.67 or elastography greater than 9.6 kPa in patients without a biopsy. PASI score greater than 10 indicated severe psoriasis, and each patient’s highest historic PASI score was considered.

Hepatic biopsy was performed in 34% of patients, revealing steatosis greater than 30% in 59.1% of patients, steatohepatitis in 63.3% and fibrosis between stages F3 and F4 in 9.1%.

Nieto and colleagues performed a linear regression analysis of hepatic and dermatologic characteristics. Results of this and a multivariate analysis demonstrated that age and highest PASI were linked with elastography values: age-related B coefficient of 0.18 (95% CI, 0.03-0.32) and PASI-associated B coefficient of 0.26 (95% CI, 0.09-0.43). – by Stacey L. Adams

Reference:

Nieto D, et al. Psoriasis severity is related to the severity of nonalcoholic fatty liver disease. Presented at: 28th European Academy of Dermatology and Venereology Congress; Oct. 9-13, 2019; Madrid.

Disclosure: Healio Dermatology was unable to confirm any relevant financial disclosures at the time of publication.