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NAFLD common in patients with psoriasis

Among a cohort of adults with psoriasis, nonalcoholic fatty liver disease was common, according to study data.

“While there have been several reports connecting psoriasis and psoriatic arthritis with NAFLD, there are no studies utilizing liver biopsy to establish the prevalence of [nonalcoholic steatohepatitis] in this group of patients,” the researchers wrote. “The aim of this study was to determine the prevalence and severity of NAFLD and NASH in an adult population with psoriasis without known liver disease.”

Researchers, including Stephen A. Harrison, MD, of San Antonio Military Medical Center, analyzed data from questionnaires, skin evaluations and other laboratory work of 103 patients with psoriasis or arthritis psoriasis to determine whether NAFLD or NASH was common in this type of population. All patients were enrolled and followed for 24 months by the dermatology or rheumatology department at San Antonio Military Medical Center. Most patients were middle-aged (52.7 ± 12 years), obese or overweight (average BMI, 30.1 ± 5.9 kg/m²), and 53% of patients were men.

NAFLD was found to be prevalent in 47% of all patients, and 22% of all patients had NASH. Seventy-six participants were offered a liver biopsy, which 52 agreed to. Forty participants who underwent liver biopsy had NAFLD, whereas 12 had no evidence of NAFLD.

The patients with psoriasis and NAFLD had higher ferritin levels compared with those without NAFLD (201.2 ± 201.5 ng/mL vs. 112.5 ± 109.6 ng/mL; P=.008) and higher psoriasis area severity index scores (5.2 ± 5 vs. 3 ± 2.7; P=.01). Patients with NASH were more likely to be obese compared with patients without NASH (91% vs. 60%; P=.01) and also had higher insulin levels (29.4 ± 21 mcIU/mL vs. 15.2 ± 8 mcIU/mL; P=.006).

NAFLD prevalence was more likely found among Hispanic patients (83%) compared with white (39%) and black patients (33%).   

“Our data suggest that the prevalence of NAFLD among middle-aged US adult patients with psoriasis is similar to the general middle-aged US population without psoriasis. … Further studies are needed to clarify the mechanisms behind this increased prevalence,” the researchers concluded. “In the meantime, health care providers evaluating and following patients with psoriasis should be mindful of this potentially harmful liver disease that is frequently found in psoriasis patients.”

Disclosure: Harrison reports serving as a consultant/adviser for AbbVie, CLDF, Fibrogen, Merck, NGM Biopharmaceuticals and Nimbus Discovery, as well as is a speaker for AbbVie, Gilead and Janssen, and is an associate editor for Hepatology.