Association between psoriasis and fatty liver disease

29 January, 2015

(3) Association between psoriasis and fatty liver disease

Psoriasis is a systemic inflammatory disease. According to statistics from the National Health Insurance, patients with psoriasis have 2.7 times greater risk of developing fatty liver disease than non-psoriasis patients. Psoriasis severity is also linked with the risk of fatty liver disease. Patients with moderate-severe psoriasis have an elevated risk of nonalcoholic fatty liver disease than those with mild psoriasis. The connection between psoriasis and fatty liver disease was rarely mentioned, however with advances in medical science, more psoriasis-related comorbidity are being identified and discussed.

Fatty liver disease is the result of the accumulation of excess fat in liver cells, making the liver cells fattier. Under normal condition, fat accounts for 3% of how much the liver weighs. A person has a fatty liver when fat makes up at least 5% of the liver. There are two types of fatty liver disease: alcoholic liver disease; nonalcoholic fatty liver disease. The information provided here refers to nonalcoholic fatty liver disease. You might be wondering whether fatty liver disease is linked with hepatitis or liver cirrhosis. Let’s first look at the progression of fatty liver disease. Among the general population, 5-40% of those with normal liver will develop nonalcoholic fatty liver disease, and the prevalence rate of hepatitis (nonalcoholic liver disease) among those with nonalcoholic fatty liver disease is 6-13%. At this stage, interventions such as dietary and lifestyle modification, and drug treatment will be required. Never take chances and overlook the condition. The prevalence rate of liver cirrhosis in those with hepatitis is 10-29% and it generally takes 10 years to progress to liver cirrhosis. The prevalence rate of liver cancer among those with liver cirrhosis is 4-27%. Although fatty liver disease may not aggravate to become subsequent diseases, self-monitoring and management of health should never be neglected.

After introducing nonalcoholic fatty liver disease, let’s take a look at the correlation between psoriasis and nonalcoholic fatty liver disease. Psoriasis is a systemic inflammatory disease and systemic inflammation worsens when compounded by obesity and smoking, leading to insulin resistance. Simply speaking, insulin resistance is when cells ignore notices from insulin and bar glucose from entering the cells. When glucose cannot enter the cells, blood sugar level remains elevated. At this stage, the pancreatic beta cells detect high blood sugar level and continue insulin secretion. This is why people with insulin resistance have increased blood sugar insulin levels. Long-term complications of insulin resistance include liver cell or fat cell damage, leading to free radical and TNF-α production that perpetuates damage to liver tissue. TNF-α production also exacerbates skin conditions, such as skin cell overproduction, in psoriasis patients.

So how do we prevent the possibility of nonalcoholic fatty liver disease? The keys are dietary modification, weight loss, exercise, and eliminate sedentary lifestyle.

There are numerous psoriasis-related comorbidities and they should never be ignored.

Information provided above is compiled by the academic department of Psoriasis Association Taiwan. Please acknowledge the source when citing.