Patients with psoriasis are at a higher risk of developing nonalcoholic fatty liver disease

Abedini, Robabeh; Salehi, Mohammad; Lajevardi, Vahideh; Beygi, Sara

doi:10.1111/ced.12672

Cited by 71 publications

(84 citation statements)

References 20 publications

(24 reference statements)

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“…18 Several studies have found an increased risk for NAFLD independent of obesity in adults with psoriasis. 35,36 Pediatric studies are needed to test for this risk in childhood psoriasis.…”

Section: Methodsmentioning

confidence: 99%

Pediatric Psoriasis Comorbidity Screening Guidelines

et al. 2017

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IMPORTANCE-Psoriasis is a complex inflammatory skin condition associated with serious medical comorbidities in adults, including obesity, hypertension, dyslipidemia, type 2 diabetes mellitus, psoriatic arthritis, nonalcoholic fatty liver disease, depression, anxiety, and decreased quality of life. Because psoriasis begins in childhood in almost one-third of patients, early identification of risk may be critical to minimizing effects on future health. OBJECTIVE-To develop the first set of guidelines for comorbidity screening for patients with pediatric psoriasis based on current evidence. EVIDENCE REVIEW-A literature review was performed using PubMed from January 1999 through December 2015. Limiting the search to human studies published in English and removing reviews and editorials produced 153 relevant manuscripts. An expert panel in psoriasis, pediatric dermatology, pediatric rheumatology, pediatric gastroenterology, pediatric endocrinology, and adult and pediatric cardiology used the patient-centered Strength of Recommendation Taxonomy (SORT) method to evaluate and grade the quality of evidence.FINDINGS-Because of the limited number of pediatric studies published on these topics, the strength of the panel's recommendations is classified as SORT level C expert consensus recommendations. The majority of recommendations coincide with those endorsed by the American Academy of Pediatrics for the general pediatric patient but with added attention to signs Osier et al.

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“…18 Several studies have found an increased risk for NAFLD independent of obesity in adults with psoriasis. 35,36 Pediatric studies are needed to test for this risk in childhood psoriasis.…”

Section: Methodsmentioning

confidence: 99%

Pediatric Psoriasis Comorbidity Screening Guidelines

et al. 2017

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“…In several studies, the presence and severity of psoriasis correlated with the prevalence, severity, and NAFLD risk (Fig. ) . Compared with patients with psoriasis alone, patients with psoriasis and NAFLD had more severe psoriasis, and NAFLD was a significant predictor of higher Psoriasis Area and Severity Index (PASI) scores .…”

Section: The Evidence: a Link Between Psoriasis And Nonalcoholic Fattmentioning

confidence: 99%

“…Compared with patients with psoriasis alone, patients with psoriasis and NAFLD had more severe psoriasis, and NAFLD was a significant predictor of higher Psoriasis Area and Severity Index (PASI) scores . Conversely, PASI was a significant and independent predictor of NAFLD grade . Additionally, patients with mild‐to‐moderate psoriasis were less likely than those with moderate‐to‐severe psoriasis to have comorbid liver disease .…”

Section: The Evidence: a Link Between Psoriasis And Nonalcoholic Fattmentioning

confidence: 99%

“…Initial case reports documented psoriasis in three patients with NASH, a patient with NASH and comorbid type 2 diabetes and psoriasis, and a patient with psoriasis, increased insulin resistance markers, elevated liver enzymes and NASH . Thereafter, investigations into a possible link between psoriasis and NAFLD ensued, and in each controlled retrospective or prospective study, the prevalence of NAFLD was significantly higher in patients with psoriasis than in healthy or matched controls (17–66% vs. 8–35%, respectively) . Additionally, patients with psoriasis were at significantly increased risk for NAFLD than controls (odds ratio 2·15) in a systematic review and meta‐analysis of seven case–controlled studies, six of which assessed risk of NAFLD among individuals with and without psoriasis …”

Section: The Evidence: a Link Between Psoriasis And Nonalcoholic Fattmentioning

confidence: 99%

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Nonalcoholic fatty liver disease in patients with psoriasis: a consequence of systemic inflammatory burden?

Prussick

Miele

2018

Br J Dermatol

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Summary Patients with psoriasis are at an increased risk for nonalcoholic fatty liver disease (NAFLD) compared with the general population. However, the pathophysiology underlying this comorbidity and elucidation of effective treatment strategies are unclear. This review provides insights into the possible role of chronic, low‐grade inflammation in the pathogenesis of NAFLD in patients with psoriasis. Both conditions are associated with increased levels of proinflammatory adipokines (such as tumour necrosis factor‐α and interleukin‐6) and hepatokines, and decreased levels of adiponectin, an anti‐inflammatory adipokine. This imbalance in inflammatory mediators could result in insulin resistance and, thereby, facilitate the occurrence and progression of NAFLD in a multistep manner. All patients with psoriasis should, therefore, be considered candidates for NAFLD screening and managed accordingly. Given the common aetiology of inflammation between these conditions, it is hypothesized that biological therapies for psoriasis may attenuate the systemic inflammatory process and progression of NAFLD in patients with psoriasis.

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“…Psoriasis is associated with NAFLD even after taking into account MetS components and other potential confounding factors. Several researchers believe that psoriatic patients are more likely to develop advanced forms of NAFLD than non-psoriatic controls and that NAFLD patients have more severe psoriasis than those without it[158-162]. A recent meta-analysis by Candia et al[163] of seven case-control studies has found that psoriatic patients have a twofold higher rate of NAFLD compared with people without psoriasis.…”

Section: Nonalcoholic Fatty Liver Disease and Psoriasismentioning

confidence: 99%

Nonalcoholic fatty liver disease - A multisystem disease?

Mikolašević

Milić

Wensveen

et al. 2016

WJG

154

155

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Non-alcoholic fatty liver disease (NAFLD) is one of the most common comorbidities associated with overweight and metabolic syndrome (MetS). Importantly, NAFLD is one of its most dangerous complications because it can lead to severe liver pathologies, including fibrosis, cirrhosis and hepatic cellular carcinoma. Given the increasing worldwide prevalence of obesity, NAFLD has become the most common cause of chronic liver disease and therefore is a major global health problem. Currently, NAFLD is predominantly regarded as a hepatic manifestation of MetS. However, accumulating evidence indicates that the effects of NAFLD extend beyond the liver and are negatively associated with a range of chronic diseases, most notably cardiovascular disease (CVD), diabetes mellitus type 2 (T2DM) and chronic kidney disease (CKD). It is becoming increasingly clear that these diseases are the result of the same underlying pathophysiological processes associated with MetS, such as insulin resistance, chronic systemic inflammation and dyslipidemia. As a result, they have been shown to be independent reciprocal risk factors. In addition, recent data have shown that NAFLD actively contributes to aggravation of the pathophysiology of CVD, T2DM, and CKD, as well as several other pathologies. Thus, NAFLD is a direct cause of many chronic diseases associated with MetS, and better detection and treatment of fatty liver disease is therefore urgently needed. As non-invasive screening methods for liver disease become increasingly available, detection and treatment of NAFLD in patients with MetS should therefore be considered by both (sub-) specialists and primary care physicians.

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Patients with psoriasis are at a higher risk of developing nonalcoholic fatty liver disease

Cited by 71 publications

References 20 publications

Pediatric Psoriasis Comorbidity Screening Guidelines

Pediatric Psoriasis Comorbidity Screening Guidelines

Nonalcoholic fatty liver disease in patients with psoriasis: a consequence of systemic inflammatory burden?

Nonalcoholic fatty liver disease - A multisystem disease?

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