Non-alcoholic Fatty liver Disease in Patients with Psoriasis - Therapeutic Implications

Abstract

Non-alcoholic fatty liver disease (NAFLD) is the most common liver pathology in the western countries. Psoriatic patients are at higher risk of having NAFLD, and at higher risk of experiencing a more severe form of the disease with poorer outcomes. The components of the metabolic syndrome-obesity, lipid abnormalities, hypertension, and type 2 diabetes-significantly correlate with NAFLD progression. The inflammatory state present in psoriasis plays a significant role in development of NAFLD and the metabolic syndrome. All patients with psoriasis and insulin resistance and risk factors for metabolic syndrome should also been screened for NAFLD, and planning of the treatment options should always take into consideration the possible risks related to the liver, especially in patients with NAFLD.

Non-alcoholic fatty liver disease in patients with intestinal, pulmonary or skin diseases: Inflammatory cross-talk that needs a multidisciplinary approach

“…From a practical perspective, the psoriasis-NAFLD association not only has an impact on the severity of skin and liver lesions, but may also influence dermatologists’ decisions when selecting systemic treatment for psoriasis[ 62 , 79 ].…”

“…Although some studies associate methotrexate liver toxicity with cumulative dose and treatment time, most find that the risk of liver damage is primarily related to the presence of risk conditions such as obesity, DM2, alcohol consumption, and NAFLD[ 80 , 81 ]. Cyclosporine and acitretin, a retinoid derived from vitamin A, are considered to be diabetogenic and to promote atherogenic dyslipemia and arterial hypertension[ 79 , 82 ].…”

“…It has been speculated that new biologic drugs could be beneficial in patients with psoriasis and NAFLD by acting on the proinflammatory cytokines involved in both diseases[ 63 ]. Although controlled studies with some tumor necrosis factor-alpha inhibitors have demonstrated their ability to decrease insulin resistance and the risk of DM2 (etanercept), others appear to favor weight gain and dyslipemia (infliximab, adalimumab)[ 79 ]. Recent research studies in animals have shown that IL-17 is involved in the progression of hepatic steatosis to NASH.…”

Serum concentration of endocan, fetuin-A, and endothelin in plaque psoriasis – coincidence or fate? A preliminary study

“…Dotyczy około 2% populacji ogólnej [1]. Ostatnio wiele dowodów wskazuje, że PV nie jest chorobą ograniczoną wyłącznie do skóry, ale powinna być zaliczana do schorzeń metabolicznych ze względu na jej współistnienie z innymi zaburzeniami, takimi jak nadciśnienie tętnicze [2], niealkoholowe stłuszczenie wątroby [3], cukrzyca [4], otyłość [5] lub hipercholesterolemia [6]. Wskazuje się, że częstsze występowanie zaburzeń metabolicznych współistniejących z PV niż w grupie kontrolnej jest spowodowane ogólnoustrojowym stanem zapalnym, jednak nie udało się dotąd usystematyzować zależności między nimi.…”

“…Dermatology Review/Przegląd Dermatologiczny 2021/1 introduction Psoriasis vulgaris (PV) is one of the most common dermatoses and affects up to 2% of the general population [1]. Much recent evidence has shown that PV is not only limited to the skin, but should be considered as a metabolic disease due to the coexistence with, e.g., hypertension [2], non-alcoholic fatty liver disease [3], diabetes mellitus [4], obesity [5], or hypercholesterolaemia [6]. It has been suggested that increased prevalence of metabolic disturbances coexisting with PV is caused by systemic inflammation; however, no exact connections have been established yet.…”