Psoriasis associated with nonalcoholic fatty liver disease: JAMA

Recent studies have shown an association between psoriasis and nonalcoholic fatty liver disease (NAFLD) in US inpatients, but the association is still unclear in the outpatient US population.

A study was conducted to assess whether psoriasis is associated with nonalcoholic fatty liver disease in outpatient US adults.

This population-based cross-sectional study used data on US adults aged 20 to 59 years from the National Health and Nutrition Examination Survey (NHANES) 2003-2006 and 2009-2014 cycles. Data were analyzed from June to September 2021.

Results:

• Among 5672 adults included in this study, 148 (3.0%) had psoriasis and 5524 (97.0%) did not have psoriasis. A total of 1558 participants (26.8%) were classified as having nonalcoholic fatty liver disease.
• Compared with participants without psoriasis, those with psoriasis had a higher prevalence of nonalcoholic fatty liver disease
• In a multivariable logistic regression model adjusted for age, sex, race and ethnicity, educational level, family income, marital status, NHANES cycles, diabetes, metabolic syndrome, and smoking and alcohol drinking status, psoriasis was associated with NAFLD
• In subgroup analyses, psoriasis was associated with nonalcoholic fatty liver disease among men among those aged 20 to 39 years and among those without diabetes
• An association between psoriasis and nonalcoholic fatty liver disease was found in sensitivity analyses that excluded potential hepatotoxic medication use or non-Hispanic Black participants, redefined nonalcoholic fatty liver disease based on the hepatic steatosis index score and used inverse probability of treatment weighting

Thus, the researchers concluded that in this cross-sectional study, psoriasis was associated with nonalcoholic fatty liver disease in the outpatient US adult population in adjusted models. This association may be important to consider in the context of clinicians prescribing potentially hepatotoxic medication for psoriasis management.

Reference:

Ruan Z, Lu T, Chen Y, et al. Association Between Psoriasis and Nonalcoholic Fatty Liver Disease Among Outpatient US Adults. JAMA Dermatol. 2022;158(7):745–753.

doi:10.1001/jamadermatol.2022.1609