Mahajan Vikram K, Chauhan Narvir S, Rana Baldev S, Mehta Karaninder S, Hooda Sheenam, Chauhan Pushpinder S, Kukreja Amisha
Department of Dermatology, Venereology & Leprosy, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), 176001 Himachal Pradesh, India.
Department of Radio Diagnosis, Dr. Rajendra Prasad Government Medical College, Kangra (Tanda), 176001 Himachal Pradesh, India.
J Clin Exp Hepatol. 2022 May-Jun;12(3):785-792. doi: 10.1016/j.jceh.2021.11.016. Epub 2021 Dec 3.
Psoriasis is a chronic dermatosis with potential to cause systemic disease by triggering dysmetabolism, such as metabolic syndrome and nonalcoholic fatty liver disease (NAFLD). We studied the relationship and associations between NAFLD and clinical features, including age, gender, disease duration, and severity of psoriasis in our patients.
This cross-sectional study comprised 61 (m:f, 43:19) patients without pre-existing comorbidities and matched 24 (m:f, 16:8) healthy controls aged between 20 and 68 years. Disease severity was graded as mild, moderate, and severe by psoriasis area and severity index score and body surface area (BSA) involvement. The grades of fatty liver and liver fibrosis were assessed using liver ultrasonography (USG) and transitional vibration-controlled elastography (Fibroscan).
Overall, 67.2% of patients were aged >40 years, and the duration of disease was <5years in 60.7% of patients. Mild and moderate to severe psoriasis occurred in 78.7% and 21.3% of patients, respectively. BSA was >10% in 57.5% patients. The proportion of NAFLD was 27.9% and 32.8% by USG and Fibroscan compared with 20.8% in controls. Statistically, there was no significant difference or association between the prevalence of NAFLD among patients and controls, and gender, age (mean ± standard deviation, 47.5 ± 13.8 vs. 45.2 ± 15.7), duration, severity of psoriasis, and arthritis between psoriatic patients with and without NAFLD.
This was a pilot study because of the numerosity of sample and highlights trends for possible link between psoriasis and NAFLD, but the results need cautious interpretation and clinical application. Whether NAFLD can be attributed to overall systemic inflammatory process of psoriasis or it occurs as an epiphenomenon of concurrent metabolic syndrome needs elucidation with well-designed studies. Cross-sectional study design, small number of patients, and controls remain major limitations. The study did not compare its findings with liver biopsy.
银屑病是一种慢性皮肤病，有可能通过引发代谢紊乱，如代谢综合征和非酒精性脂肪性肝病（NAFLD），导致全身性疾病。我们研究了NAFLD与临床特征之间的关系及关联，这些临床特征包括我们患者的年龄、性别、病程和银屑病严重程度。
这项横断面研究纳入了61例（男:女，43:19）无既往合并症的患者，并匹配了24例（男:女，16:8）年龄在20至68岁之间的健康对照。根据银屑病面积和严重程度指数评分及体表面积（BSA）受累情况，将疾病严重程度分为轻度、中度和重度。使用肝脏超声检查（USG）和瞬时弹性成像（Fibroscan）评估脂肪肝和肝纤维化的分级。
总体而言，67.2%的患者年龄>40岁，60.7%的患者病程<5年。轻度和中度至重度银屑病分别发生在78.7%和21.3%的患者中。57.5%的患者BSA>10%。通过USG和Fibroscan评估的NAFLD比例分别为27.9%和32.8%，而对照组为20.8%。在统计学上，患者和对照组中NAFLD的患病率之间，以及有无NAFLD的银屑病患者之间，在性别、年龄（平均值±标准差，47.5±13.8 vs. 45.2±15.7）、病程、银屑病严重程度和关节炎方面，均无显著差异或关联。
由于样本数量较少，这是一项初步研究，突出了银屑病与NAFLD之间可能存在联系的趋势，但结果需要谨慎解读和临床应用。NAFLD是可归因于银屑病的整体全身炎症过程，还是作为并发代谢综合征的一种附带现象发生，需要通过精心设计的研究来阐明。横断面研究设计、患者和对照数量较少仍然是主要局限性。该研究未将其结果与肝活检结果进行比较。
