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Abstract Background: The risk factors for liver fibrosis (LF) in psoriasis patients and the effects of biologic treatments on LF remain unclear. Objectives: The objective of the study was to investigate the prevalence and associated risk factors of fatty liver and LF in patients with psoriasis vulgaris and to assess the impact of biologic treatments on LF. Methods: In this single-center retrospective study, ultrasound and shear wave elastography (SWE) were used to assess steatosis and LF in psoriasis patients, respectively. We compared the characteristics of psoriasis patients with and without fatty liver or LF. In addition, we compared liver stiffness measurement (LSM) levels before and after 1 year of biologic treatment. Results: A total of 239 patients underwent liver ultrasound, and 108 (45.19%) were found to have fatty liver. Univariate analysis revealed significant differences in disease severity, duration, age, gender, body mass index (BMI), liver function, blood glucose, and lipid levels between patients with and without fatty liver. Binary logistic regression analysis showed that the presence of fatty liver is associated with psoriasis duration, BMI, abnormal blood lipids, and liver function. A total of 126 patients underwent two-dimensional SWE analysis, with liver stiffness values ranging from 6.50 (5.28, 7.81) kPa. Among them, 45 patients (35.71%) had high liver stiffness. Univariate analysis revealed that age, BMI, blood glucose, and lipid abnormalities significantly differed between patients with and without LF. Binary logistic regression indicated that LF in psoriasis patients was associated with age and BMI. There were no statistically significant differences in LSM levels before and after treatment with interleukin (IL)-17A (45 patients) and IL-23 (16 patients) inhibitors. However, in patients with baseline LSM >7.04 kPa, significant reductions in LSM were observed in those treated with IL-17A inhibitors(15 patients), but not in those treated with IL-23 inhibitors(4 patients). Conclusion: The prevalence of fatty liver (45.19%) and LF (35.71%) in psoriasis patients is higher than in the general population, indicating an increased risk of nonalcoholic fatty liver disease. Psoriasis duration, BMI, abnormal blood lipids, and liver function are significant risk factors for fatty liver, while age and BMI are risk factors of liver fibrosis. IL-17A inhibitors, after 1 year of treatment, can reduce liver stiffness in psoriasis patients with LF.
Gu et al. (Tue,) studied this question.