Hizli Pelin, Oğuz Işıl Deniz, Kulakli Sevgi, Kiliç Fatma Arzu, Duyan Ayser
Department of Dermatology, Faculty of Medicine, Balikesir University, Balikesir, Turkey.
Department of Dermatology, Faculty of Medicine, Giresun University, Giresun, Turkey.
Arch Dermatol Res. 2024 Jun 28;316(7):437. doi: 10.1007/s00403-024-03193-9.
Psoriasis might bring about an increased risk of liver diseases like nonalcoholic fatty liver disease and fibrosis. The impact of methotrexate on liver function is still a cause for concern, because of the studies suggesting an increased risk of liver damage and others finding no association. The focus of this study was the liver functions in psoriatic patients investigating the impact of long-term use of methotrexate on liver in psoriasis. A retrospective investigation including 140 patients with psoriasis receiving methotrexate treatment for at least 6 months and a control group consisted of 105 healthy ones was conducted. Liver function tests (AST, ALT, PLT) were assessed, and the association of baseline PASI with FIB-4 and APRI values was investigated. Additionally, FIB-4 and APRI values at baseline, 3rd, and 6th months of methotrexate treatment for psoriasis were compared. Compared with the controls, psoriatic patients exhibited significantly higher FIB-4 scores (p = 0.004). A moderate and significant correlation was observed between baseline PASI score and baseline FIB-4 score in psoriatic patients (p < 0.001, rho = 0.626). Long-term methotrexate use had no effect on APRI or FIB-4 (p = 0.104 and p = 0.475, respectively). Psoriatic patients face an elevated risk of liver fibrosis. Long-term methotrexate use does not adversely affect liver function in psoriatic patients. Noninvasive tools like APRI and FIB-4 scores can be employed to evaluate the risk of liver disease in these patients.
银屑病可能会增加患非酒精性脂肪性肝病和肝纤维化等肝脏疾病的风险。甲氨蝶呤对肝功能的影响仍然令人担忧，因为一些研究表明肝损伤风险增加，而另一些研究则未发现关联。本研究的重点是银屑病患者的肝功能，调查长期使用甲氨蝶呤对银屑病患者肝脏的影响。进行了一项回顾性研究，包括140例接受甲氨蝶呤治疗至少6个月的银屑病患者和一个由105名健康人组成的对照组。评估了肝功能测试（AST、ALT、PLT），并研究了基线银屑病面积和严重程度指数（PASI）与FIB-4和天冬氨酸氨基转移酶与血小板比值指数（APRI）值的关联。此外，还比较了银屑病患者甲氨蝶呤治疗基线、第3个月和第6个月时的FIB-4和APRI值。与对照组相比，银屑病患者的FIB-4评分显著更高（p = 0.004）。在银屑病患者中，观察到基线PASI评分与基线FIB-4评分之间存在中度且显著的相关性（p < 0.001，rho = 0.626）。长期使用甲氨蝶呤对APRI或FIB-4没有影响（分别为p = 0.104和p = 0.475）。银屑病患者面临肝纤维化风险升高。长期使用甲氨蝶呤不会对银屑病患者的肝功能产生不利影响。像APRI和FIB-4评分这样的非侵入性工具可用于评估这些患者的肝脏疾病风险。
