Liver Stiffness Measurement in Psoriasis: Do Metabolic or Disease Factors Play the Important Role?

Jamrus Pongpit,Saneerat Porntharukchareon,Supanna Petraksa,Piyaporn Kaewduang,Kwannapa Promson,Chomsri Kositchaiwat,Natta Rajatanavin,Wasana Stitchantrakul,Ammarin Thakkinstian,Abhasnee Sobhonslidsuk

doi:10.1155/2016/7963972

Jamrus Pongpit, Saneerat Porntharukchareon + Show 8 more

Open Access

https://doi.org/10.1155/2016/7963972

Copy DOI

Abstract

Background. An increased prevalence of metabolic syndrome including nonalcoholic fatty liver disease (NAFLD) was reported in psoriasis. NAFLD can progress to nonalcoholic steatohepatitis and fibrosis. Transient elastography (TE) is a noninvasive liver fibrosis assessment. We evaluated the prevalence of significant liver fibrosis or high liver stiffness measurement (LSM) using the LSM cutoff over 7 kPa and its associated factors in psoriatic patients. Methods. Subjects underwent TE and ultrasonography. Univariate and multivariate analysis were performed for the associated factors. Results. One hundred and sixty-eight patients were recruited. Three patients were excluded due to TE failure. Mean BMI was 24.8 ± 4.7 kg/m2. NAFLD, metabolic syndrome, and diabetes were seen in 105 (63.6%), 83 (50.3%), and 31 (18.8%) patients. The total cumulative dose of methotrexate over 1.5 g was seen in 39 (23.6%) patients. Mean LSM was 5.3 ± 2.9 kPa. High LSM was found in 18 (11.0%) patients. Waist circumference (OR: 1.24; 95% CI: 1.11–1.38; P = 0.0002), diabetes (OR: 12.70; 95% CI: 1.84–87.70; P = 0.010), and AST (OR: 1.08; 95% CI: 1.02–1.16; P = 0.017) were associated with high LSM. Conclusion. 11% of psoriatic patients had significant liver fibrosis by high LSM. Waist circumference, diabetes, and AST level were the independent predictors.

Highlights

Psoriasis is a chronic inflammatory immune-mediated skin disease affecting 1–3% of the world population
The aims of the present study were to investigate the prevalence of significant liver fibrosis or high liver stiffness measurement (LSM) assessed by Transient elastography (TE) and to evaluate the factors that were associated with high LSM in patients with psoriasis
Six (3.2%) patients had psoriasis area and severity index (PASI) scores > 10, which was correlated with disease factors reflecting the severity of psoriasis, for example, hospital admission and the requirement of systemic therapy

Summary

Introduction

Psoriasis is a chronic inflammatory immune-mediated skin disease affecting 1–3% of the world population. Metabolic syndrome is a risk factor for the development of nonalcoholic fatty liver disease (NAFLD). The recently revised consensus stated that psoriatic patients without concomitant diseases should receive liver biopsy when the total cumulative dose of methotrexate reached 3.5–4 g [10]. In addition to methotrexate use, metabolic syndrome and psoriasis-related factors, such as the duration and severity of disease, as well as the presence of joint involvement, may play important roles in the development of significant liver fibrosis [7, 11]. An increased prevalence of metabolic syndrome including nonalcoholic fatty liver disease (NAFLD) was reported in psoriasis. We evaluated the prevalence of significant liver fibrosis or high liver stiffness measurement (LSM) using the LSM cutoff over 7 kPa and its associated factors in psoriatic patients. Diabetes, and AST level were the independent predictors

Objectives

Methods

Results

Discussion

Conclusion