A higher prevalence of NAFLD was observed among patients with psoriasis without arthritis compared with patients with psoriatic arthritis.
Study data published in Clinical Rheumatology suggest that insulin resistance, rather than arthritis, may predict nonalcoholic fatty liver disease (NAFLD) in patients with psoriasis. In fact, a higher prevalence of NAFLD was observed among patients with psoriasis (PsO) without arthritis compared with patients with psoriatic arthritis (PsA).
Adult patients with PsO and PsA were consecutively enrolled over a 9-month period from the rheumatology and dermatology units of the University of Padova in Italy. Exclusion criteria were liver diseases other than NAFLD, alcohol consumption ≥20 g/day, daily use of nonsteroidal anti-inflammatory drugs, and current or prior methotrexate use. After enrollment, patients attended a single study visit where they provided demographic and clinical data. Serologic samples were taken to assess biomarker levels. Insulin resistance was evaluated through the homeostatic model assessment (HOMA) index. Patients also underwent liver ultrasound to identify the presence of NAFLD. Transient elastography was performed to evaluate the presence and grading of liver fibrosis, with stiffness ≥7 kPa denoting fibrosis. Multivariable regression analyses were performed to identify the contribution of arthritis to NAFLD and liver stiffness in the whole cohort.