Psoriasis linked to nonalcoholic fatty liver disease in US adults
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Researchers found that psoriasis correlated with nonalcoholic fatty liver disease among adults, based on data from the National Health and Nutrition Examination Survey.
The prevalence of nonalcoholic fatty liver disease (NAFLD) has been increasing in the U.S. in recent years and continues to lead to liver transplant and mortality among patients who develop the condition.
“The association between psoriasis and NAFLD appears to be biologically plausible,” Zhijie Ruan, MMed, from the First Affiliated Hospital of Shantou University Medical College in China, and colleagues wrote. “In addition to being common comorbidities of psoriasis, metabolic syndrome and its components are associated with development of NAFLD.”
To assess the connection between psoriasis and NAFLD, Ruan and colleagues reviewed NHANES data on U.S. adults aged 20 to 59 years from two time periods: 2003 to 2006 and 2009 to 2014. The study comprised 5,672 patients, of whom 148 had psoriasis and 1,558 had NAFLD.
The prevalence of NAFLD was higher among patients with psoriasis compared with those without psoriasis (32.7% vs. 26.6%).
The researchers also found that patients with psoriasis vs. those without psoriasis were older (mean age, 41.4 years vs. 38.8 years), and a greater proportion were non-Hispanic white (82.3% vs. 67.3%) and had an education level of college or higher (38.3% vs. 31.2%).
Multivariate analysis confirmed the link between psoriasis and NAFLD based on a model adjusted for sociodemographic variables, NHANES cycles, metabolic syndrome, diabetes and smoking and drinking status (OR = 1.67; 95% CI, 1.03-2.7); and another model adjusted for sociodemographic variables, NHANES cycles, metabolic syndrome and diabetes, not including smoking or drinking status (OR = 1.7; 95% CI, 1.06-2.72).
An additional subgroup analysis showed that psoriasis was associated with NAFLD among patients aged 20 to 39 years (OR = 2.48; 95% CI, 1.09-5.67), men (OR = 2.16; 95% CI, 1.1-4.24) and patients without diabetes (OR = 1.7; 95% CI, 1.05-2.76).
The researchers noted several limitations to the study, including the cross-sectional nature; residual confounders that could be present, such as obesity; and the difficulty in applying liver biopsy data in a population-based study.
“The association between psoriasis and NAFLD may be bidirectional owing to their similar biological mechanisms,” Ruan and colleagues wrote. “Because some antipsoriatic agents are potentially hepatotoxic, this finding may be important for clinicians to consider for psoriasis management.