Relationship psoriasis and NAFLD: new data on the hepato-dermal axis

A Spanish study showed for the first time that more severe hepatic damage is evident in patients with both psoriasis and non-alcoholic fatty liver disease (NAFLD) [1].

Over the past 10 years, it has become increasingly evident that NAFLD is a multisystemic disease that affects extra-hepatic organ systems and interacts with the regulation of several metabolic and immunological pathways [2]. The prevalence of NAFLD (diagnosed by imaging or by histology) is remarkably higher in psoriatic patients, occurring in up to 50% of patients [2]. Of note, this association is evident even after adjusting for metabolic syndrome traits or other potential confounders. Up to now, no reports on a possible link between the severity of both conditions have been published.

To explore a possible association, a total of 64 male patients were included in a prospective 12-month study. Inclusion criteria were NAFLD (histologic steatosis >5%, sonographic steatosis >48 dB/m, no other hepatic conditions, and less than 30 g/d of alcohol intake) and severe psoriasis. Patients enrolled in the trial had a considerable comorbidity: their mean body mass index was 30.9 kg/m2, 53.1% had diabetes mellitus, and 42.2% suffered from hypertension. The Psoriasis Area and Severity Index score was used to measure the severity of psoriasis, while ultrasound elastography was used to judge the severity of NAFLD.

Results showed that psoriatic patients with NAFLD had indeed more severe elastographic hepatic damage if they had a higher level of psoriasis severity. “In this context, increasing awareness and the continued assessment of the severity of NAFLD in patients with psoriasis by primary care physicians, specialists, health policymakers, and patients should be prioritised to help manage both conditions,” said lead researcher Dr Daniel Nieto (La Paz Hospital, Spain).

1. 
   
   1. Nieto D, et al. Poster No 169, EADV 2019, 9-13 Oct, Madrid, Spain.
   2. Mantovani A, et al. Int J Mol Sci 2016;17:217.

 



Posted on 9 October 201912 March 2021