银屑病患者中胰岛素抵抗与脂肪肝之间存在正相关关系：来自横断面研究的证据。
Positive association between insulin resistance and fatty liver disease in psoriasis: evidence from a cross-sectional study.
机构信息
Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China.
出版信息
Front Immunol. 2024 Apr 23;15:1388967. doi: 10.3389/fimmu.2024.1388967. eCollection 2024.
BACKGROUND
Fatty liver disease (FLD) is a common comorbidity of psoriasis and is often referred to as non-alcoholic fatty liver disease (NAFLD). However, the role of inflammation or insulin resistance (IR) in FLD is inconclusive. The study aims to explore whether FLD in psoriasis patients is more related to insulin resistance or systemic inflammation level.
METHODS
Data for this study were collected from the Shanghai Psoriasis Effectiveness Evaluation Cohort, a prospective cohort that examines psoriasis characteristics in the Chinese population. IR was assessed using the triglyceride glucose (TyG) and TyG-body mass index (TyG-BMI) indicators. Systemic non-specific inflammation was assessed using the neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), and systemic immune inflammation index (SII).
RESULTS
The analysis included a total of 647 patients. Subsequent logistic regression analysis revealed that NLR, dNLR, and SII were not significantly associated with FLD in psoriasis patients, while TyG and TyG-BMI showed significant associations with FLD. Subgroup analysis indicated that in the majority of subgroups, TyG and TyG-BMI were significantly associated with FLD, particularly TyG-BMI. Excluding individuals with methotrexate and acitretin resulted in consistent findings with the main analysis. Further analysis revealed a significantly higher diagnosis rate of metabolic-associated fatty liver disease (MAFLD) compared to NAFLD.
CONCLUSIONS
Metabolic factors play a crucial role in FLD in patients with psoriasis, and TyG and TyG-BMI are potential predictors of FLD. Therefore, MAFLD can be recommend as a term to describe FLD in psoriasis patients.
TRIAL REGISTRATION
https://www.chictr.org.cn/showproj.html?proj=58256, identifier ChiCTR2000036186. A multi-center clinical study of systemic treatment strategies for psoriasis in Chinese population. Registered 31 August 2020.
背景
脂肪肝疾病（FLD）是银屑病的常见合并症，通常被称为非酒精性脂肪性肝病（NAFLD）。然而，炎症或胰岛素抵抗（IR）在 FLD 中的作用尚不清楚。本研究旨在探讨银屑病患者的 FLD 是否与胰岛素抵抗或全身炎症水平更相关。
方法
本研究的数据来自上海银屑病疗效评估队列，这是一个前瞻性队列，研究中国人群中银屑病的特征。IR 采用甘油三酯葡萄糖（TyG）和 TyG-体重指数（TyG-BMI）指标评估。全身非特异性炎症采用中性粒细胞与淋巴细胞比值（NLR）、衍生中性粒细胞与淋巴细胞比值（dNLR）和全身免疫炎症指数（SII）评估。
结果
分析共纳入 647 例患者。随后的逻辑回归分析显示，NLR、dNLR 和 SII 与银屑病患者的 FLD 无显著相关性，而 TyG 和 TyG-BMI 与 FLD 显著相关。亚组分析表明，在大多数亚组中，TyG 和 TyG-BMI 与 FLD 显著相关，尤其是 TyG-BMI。排除接受甲氨蝶呤和阿维 A 的个体后，与主要分析结果一致。进一步分析显示，代谢相关脂肪性肝病（MAFLD）的诊断率明显高于非酒精性脂肪性肝病（NAFLD）。
结论
代谢因素在银屑病患者的 FLD 中起关键作用，TyG 和 TyG-BMI 是 FLD 的潜在预测因子。因此，MAFLD 可被推荐用于描述银屑病患者的 FLD。
试验注册
https://www.chictr.org.cn/showproj.html?proj=58256，标识符 ChiCTR2000036186。中国人群系统性治疗银屑病的多中心临床研究。注册于 2020 年 8 月 31 日。
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