Washington Dermatology Center, Rockville, MD, U.S.A.
Department of Dermatology, George Washington University, Washington, DC, U.S.A.
Br J Dermatol. 2018 Jul;179(1):16-29. doi: 10.1111/bjd.16239. Epub 2018 May 15.
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.
与普通人群相比，银屑病患者发生非酒精性脂肪性肝病（NAFLD）的风险增加。然而，这种合并症的病理生理学基础以及阐明有效的治疗策略尚不清楚。这篇综述深入探讨了慢性、低度炎症在银屑病患者 NAFLD 发病机制中的可能作用。这两种疾病都与促炎脂肪因子（如肿瘤坏死因子-α和白细胞介素-6）和肝源因子水平升高，以及抗炎脂肪因子脂联素水平降低有关。这种炎症介质的失衡可能导致胰岛素抵抗，从而以多步骤的方式促进 NAFLD 的发生和进展。因此，所有银屑病患者都应被视为 NAFLD 筛查的候选者，并进行相应的管理。鉴于这些疾病之间存在共同的炎症病因，有人假设银屑病的生物疗法可能会减轻银屑病患者的系统性炎症过程和 NAFLD 的进展。
