A Cross-Sectional Study Investigating Association Of Liver Diseases In Moderate To Severe Psoriasis Patients

Abstract

Background and Design: Non-alcoholic fatty liver disease (NAFLD), which is a systemic comorbidity of psoriasis, is the most common liver disease in population with risk of cirrhosis progression. The aim of this study was to investigate the frequency and risk factors of NAFLD in moderate:-severe psoriasis patients. Materials and Methods: Patients aged 18 years and older, who were followed up with a diagnosis of moderate to severe psoriasis at Hacettepe University Faculty of Medicine, Department of Dermatology and Venereology between 2015 and 2016, were included. Demographic and disease-related data (age, sex, age at psoriasis onset, alcohol use, family history of psoriasis, psoriatic arthritis history), and associating systemic diseases were reviewed. Liver function tests (LFT) were evaluated during routine examinations. Evaluation of gastroenterology consultations was reviewed with indications (positive hepatitis markers, elevated LFT, liver disease history). Abdominal, liver and biliary system ultrasonography results were assessed. Descriptive stastistics were evaluated by cross-table and chi-square test. The difference between the two means was evaluated by t-tests. P value less than 0.05 were accepted as statistically significant. Results: Two hundred and sixty-six patients with moderate-severe psoriasis were included. 12% of the patients (n=31) had elevated LFT. Abdominal ultrasonography was performed in 77% (n=24) of patients who were evaluated by gastroenterology department for LFT elevation. NAFLD was found in 65% (n=20) of patients with high LFT. The incidence of coronary artery disease, hypertension and hyperlipidemia was significantly higher in patients with high LFT compared to patients with normal LFT (p=0.003, p=0.011 and p=0.001, respectively). Examination and laboratory values were compared according to presence of elevation in LFT; uric acid levels were statistically higher in psoriatic patients with high LFT (p=0.002). The mean waist circumference in patient group with elevated LFT and in group with normal LFT was found to be 108.3 +/- 9.6 cm and 98.2 +/- 15.4 cm, respectively. The difference was statistically significant (p=0.005). Conclusion: NAFLD should be kept in mind as a frequent and important cause of elevated LFT observed in psoriasis patients. The presence of comorbidities such as cardiovascular diseases, hypertension and hyperlipidemia, which are frequently observed in psoriasis patients diagnosed with NAFLD, should be investigated. We recommend measurement of waist circumference and blood pressure and parameters including fasting blood glucose, lipid profile and uric acid in terms of metabolic syndrome.