Doctors treating these patients need to be aware of the association, because some antipsoriatic agents can be damaging to the liver, the researchers advise in JAMA Dermatology. They also note that cytokines that contribute to psoriasis are associated with NAFLD development.
"Elevated TNF-alpha levels can also exacerbate insulin resistance among patients with psoriasis, which contributes to the generation and release of free fatty acids and enhances the deposition of free fatty acids in the liver. Interleukin-23 is involved in the pathogenesis of psoriasis" and insulin resistance, Dr. Zhijie Ruan and colleagues from The First Affiliated Hospital of Shantou University Medical College in Guangdong, China wrote in their report.
Dr. Ruan's team studied data on 5,672 adults aged 20 to 59 (2,999 females) who participated in the U.S. National Health and Nutrition Examination Survey (NHANES) from June 2021 to September 2021.
Overall, 148 participants reported a psoriasis diagnosis, and 1,558 reported NAFLD.
After adjusting for age, race/ethnicity, sex, diabetes, smoking, alcohol use, and other risk factors, those with psoriasis had a higher prevalence of NAFLD.
"In subgroup analyses, psoriasis was associated with NAFLD among men (OR, 2.16; 95% CI, 1.10-4.24), among those aged 20 to 39 years (OR, 2.48; 95% CI, 1.09-5.67), and among those without diabetes," the researchers reported.
"An association between psoriasis and NAFLD was found in sensitivity analyses that excluded potential hepatotoxic medication use," they added.
A limitation of the study is that the data were self-reported. Still, the authors concluded, "The findings of this cross-sectional study suggest that psoriasis is positively associated with NAFLD in the outpatient U.S. adult population. Because some antipsoriatic agents are potentially hepatotoxic, this finding may be important for clinicians to consider for psoriasis management."
SOURCE: https://bit.ly/3wP9RhB JAMA Dermatology, online May 25, 2022.
By Shawana Alleyne-Morris
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