A study linking psoriasis and metabolic dysfunction-associated steatotic liver disease (MASLD) found serum adiponectin levels and immune imbalances as critical markers, with psoriasis independently associated with MASLD in participants.
A cross-sectional analysis of participants, including psoriasis patients, healthy controls, and those with isolated MASLD, revealed that psoriasis is independently associated with MASLD, with an adjusted odds ratio of 2.282 (95% CI: 1.181–4.408, P = 0.014).
Key Findings from the Studies
The study identified that psoriasis patients with concurrent MASLD exhibited higher circulating IL-17+ Th17 cells and an increased Th17/Treg ratio, which correlated with hepatic steatosis severity. In contrast, a German study published in Psoriasis: Targets and Therapy found that patients with both conditions had significantly lower serum adiponectin levels (12.3 vs. 22.1 µg/mL, P = 0.042), though this difference was partly explained by BMI.
The research noted that elevated liver enzymes were associated with severe hepatic steatosis, while the analysis emphasized that MASLD frequently remains undetected in clinical routine diagnostics.
The German team defined MASLD as hepatic steatosis,
as determined via imaging and other medical records, in combination with at least one cardiometabolic risk factor, after exclusion of other liver disease and harmful alcohol use.
The study included 408 participants stratified into three groups: 206 patients with plaque psoriasis, 100 subjects undergoing routine health examinations (RHE group), and 102 patients with isolated MASLD. The study also compared 17 patients with plaque psoriasis without MASLD (MASLD-) and 42 patients with plaque psoriasis with MASLD (MASLD+).
Results from the study showed that psoriasis patients with MASLD had elevated liver stiffness measurements (LSM) (4.60[3.82-5.50] vs. 4.20[3.50-5.30] kPa, P = 0.020) and higher CAP values (261.74 ± 58.28 vs. 237.75 ± 57.26 dB/m, P. Subgroup stratification by psoriasis severity revealed no significant differences in the distribution of hepatic steatosis grades among patients with MASLD.
The German study’s analysis used Spearman correlation and BMI-adjusted multiple linear regression to examine associations. Patients in the MASLD+ cohort presented with higher total cholesterol, LDL cholesterol, BMI, and C-reactive protein (CRP), and were more likely to be diagnosed with dyslipidemia.
Implications for Clinical Practice
Findings suggest that adiponectin levels may serve as a biomarker, though further prospective studies are needed to validate its utility. Both studies stress the importance of managing patients with psoriasis and metabolic health issues as a team.
In moderate-to-severe psoriasis, concurrent MASLD is characterized by a metabolically adverse profile and reduced serum adiponectin,
the study authors concluded. They noted that as the difference is partly explained by adiponectin warrants prospective evaluation as a candidate marker of concurrent MASLD.
The study also found no significant correlation between Th17 cell proportions or the Th17/Treg ratio and psoriasis severity (P>0.05), but the Th17/Treg ratio remained significantly associated with MASLD in the binary logistic regression analysis (adjusted OR = 6.751, 95% CI: 1.026-44.404, P = 0.047).
The study population included adult psoriasis patients from Department of Dermatology, Peking University People’s Hospital. Eligible patients for the single-center retrospective study included individuals with moderate-to-severe plaque psoriasis who were admitted to the hospital between 2015 and 2024.
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