Plaque Psoriasis highly prevalent among patients with MASLD and lean MASLD, suggests study

Plaque psoriasis, the most common form of psoriasis, affects about 6.7 million adults, with 80%-90% of psoriasis patients having this type. Patients with psoriasis are at higher risk for conditions such as hepatic disease, diabetes, hypertension, obesity, metabolic syndrome, and cardiovascular disease. The relationship between psoriasis and nonalcoholic fatty liver disease (NAFLD) has been established, but the new diagnostic criteria for MASLD introduced in 2023 warranted updated research.

“Previous research indicates a relationship between the onset and severity of psoriasis with metabolic syndrome and NAFLD,” Yi Cao, professor at the First Affiliated Hospital of Zhejiang Chinese Medical University, and colleagues wrote. “This study revisits these associations using the MASLD diagnostic criteria, marking it as the first to explore the connection with psoriasis under these new guidelines.”

This retrospective, observational study was conducted at The First Affiliated Hospital of Zhejiang Chinese Medical University from January 2021 to January 2023. Patients aged 18 and older with a clinical diagnosis of plaque psoriasis were included in the observation group. A control group, matched by age, gender, and BMI, consisted of patients undergoing routine physical examinations. MASLD was diagnosed through ultrasound examination, and the incidence of MASLD and lean MASLD was compared between groups.

The study included 158 patients with plaque psoriasis and 158 matched healthy controls. Baseline characteristics such as age, height, weight, gender, and BMI were not statistically significantly different between the groups (P >.05).

• Incidence of MASLD: 43.67% in psoriasis patients vs. 22.15% in controls (P <.01).

• Incidence of lean MASLD: 10.76% in psoriasis patients vs. 4.43% in controls (P <.05).

• Diabetes and metabolic syndrome: More common in psoriasis patients (P <.05).

• Overweight, obesity, hypertension, low HDL cholesterol, and hypertriglyceridemia: No significant differences between groups (P >.05).

Plaque psoriasis was found to be an independent risk factor for MASLD (OR 1.88; 95% CI 1.10-3.21). Serological analysis revealed elevated CYFRA21-1 levels in patients with both MASLD and lean MASLD (P <.01). Inflammatory markers and psoriasis scores were higher in the MASLD group but not in the lean MASLD group.

The study highlighted the high prevalence of MASLD and lean MASLD in patients with plaque psoriasis. The significant correlation between MASLD and psoriasis severity suggests that MASLD may exacerbate psoriasis conditions. The elevation of CYFRA21-1 levels in both MASLD groups implies a synergistic relationship between psoriasis and MASLD.

Investigators noted limitations including the tertiary care center setting, the case-control design's inability to establish causality, the use of liver ultrasonography for SLD diagnosis, and the small sample size of the lean MASLD group.

Reference:

Lin Z, Shi YY, Yu LY, et al. Metabolic dysfunction associated steatotic liver disease in patients with plaque psoriasis: a case-control study and serological comparison. Front Med (Lausanne). 2024;11:1400741. Published 2024 May 15. doi:10.3389/fmed.2024.1400741