Xu Xin, Su Lina, Gao Yunlu, Ding Yangfeng
Department of Dermatology, Shanghai Dermatology Hospital, Shanghai, China.
PLoS One. 2017 Jan 18;12(1):e0169952. doi: 10.1371/journal.pone.0169952. eCollection 2017.
Nonalcoholic fatty liver disease (NAFLD) has been found to be highly prevalent in psoriatic patients. Adult onset psoriasis could be divided into either early or late onset psoriasis. The associations between NAFLD and related metabolic comorbidities and age at onset of psoriasis have not yet been investigated. Our study was to evaluate the associations between prevalence of NAFLD and related metabolic conditions and early, late, and childhood onset psoriasis. A cross-sectional observational study was conducted on patients with moderate to severe plaque psoriasis. Data on clinical characteristics of NAFLD and related metabolic diseases (diabetes, hypertriglyceridemia, hyperuricemia, and metabolic syndrome) were collected. The prevalence of NAFLD in 439 patients (mean: 51±14 years, range: 18-85 years) was 55.8%. NAFLD was frequently identified in early onset patients (74.2%), and this diagnosis was particularly common in patients currently younger than 40 (85.3%). Diabetes was the least prevalent component of metabolic syndrome in early onset patients with metabolic syndrome but the most often found component in late onset ones. Patients with childhood onset psoriasis had the lowest frequencies of all metabolic comorbidities except hyperuricemia among the three groups. In the multivariate analyses, early onset was independently and positively associated with NAFLD, hypertriglyceridemia and hyperuricemia and independently and negatively associated with diabetes among early and late onset patients. The results suggested prevalence of NAFLD and related metabolic comorbidities was associated with age at onset of moderate to severe plaque psoriasis. Early onset of psoriasis was independently associated with greater odds of NAFLD, hypertriglyceridemia, hyperuricemia and smaller odds of diabetes compared to late onset. Early onset patients have metabolic syndrome mainly related to lipid disorders and abnormal glucose metabolism was not often involved.
非酒精性脂肪性肝病（NAFLD）在银屑病患者中具有很高的患病率。成人起病型银屑病可分为早发型或晚发型银屑病。NAFLD与相关代谢合并症及银屑病起病年龄之间的关联尚未得到研究。我们的研究旨在评估NAFLD患病率与相关代谢状况以及早发型、晚发型和儿童期起病型银屑病之间的关联。对中重度斑块状银屑病患者进行了一项横断面观察性研究。收集了NAFLD及相关代谢疾病（糖尿病、高甘油三酯血症、高尿酸血症和代谢综合征）的临床特征数据。439例患者（平均年龄：51±14岁，范围：18 - 85岁）中NAFLD的患病率为55.8%。NAFLD在早发型患者中很常见（74.2%），在目前年龄小于40岁的患者中这种诊断尤为常见（85.3%）。糖尿病是早发型代谢综合征患者中最不常见的组成部分，但在晚发型患者中是最常出现的组成部分。在三组中，儿童期起病型银屑病患者除高尿酸血症外，所有代谢合并症的发生率最低。在多变量分析中，早发型在早发型和晚发型患者中与NAFLD、高甘油三酯血症和高尿酸血症独立且呈正相关，与糖尿病独立且呈负相关。结果表明，NAFLD及相关代谢合并症的患病率与中重度斑块状银屑病的起病年龄有关。与晚发型相比，早发型银屑病独立地与更高的NAFLD、高甘油三酯血症、高尿酸血症几率以及更低的糖尿病几率相关。早发型患者的代谢综合征主要与脂质紊乱有关，且异常糖代谢并不常见。
