title: Psoriasis is independently associated with nonalcoholic fatty liver disease in patients 55 years old or older: Results from a population-based study.
abstract: BACKGROUND
  Recent case-control studies observed an increased prevalence of nonalcoholic fatty liver disease (NAFLD) in patients with psoriasis, which is relevant in selecting optimal psoriasis treatment.
  
  
  OBJECTIVE
  We sought to compare the prevalence of NAFLD in people with psoriasis and those without psoriasis.
  
  
  METHODS
  This large prospective population-based cohort study (part of the Rotterdam Study) enrolled elderly participants (>55 years). NAFLD was diagnosed as fatty liver on ultrasonography in the absence of other liver diseases. Participants with psoriasis were identified using a validated algorithm. Multivariable logistic regression model was used to assess whether psoriasis was associated with NAFLD after adjusting for demographic, lifestyle characteristics, and laboratory findings.
  
  
  RESULTS
  In total, 2292 participants were included (mean age 76.2 ± 6.0 years; 58.7% female; mean body mass index 27.4 ± 4.2kg/m(2)) of whom 118 (5.1%) had psoriasis. The prevalence of NAFLD was 46.2% in patients with psoriasis compared with 33.3% for the reference group without psoriasis (P = .005). Psoriasis was significantly associated with NAFLD; after adjustment for alcohol consumption, pack-years and smoking status, presence of metabolic syndrome, and alanine aminotransferase, psoriasis remained a significant predictor of NAFLD (adjusted odds ratio 1.7, 95% confidence interval 1.1-2.6).
  
  
  CONCLUSIONS
  This was a cross-sectional study.
  
  
  CONCLUSIONS
  Elderly participants with psoriasis are 70% more likely to have NAFLD than those without psoriasis independent of common NAFLD risk factors.
authors.affiliation: Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Ella A M
authors.initials: EA
authors.lastname: van der Voort
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Edith M
authors.initials: EM
authors.lastname: Koehler
authors.affiliation: Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Emmilia A
authors.initials: EA
authors.lastname: Dowlatshahi
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Bruno H
authors.initials: BH
authors.lastname: Stricker
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Harry L A
authors.initials: HL
authors.lastname: Janssen
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Jeoffrey N L
authors.initials: JN
authors.lastname: Schouten
authors.affiliation: Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands. Electronic address: t.nijsten@erasmusmc.nl.
authors.forename: Tamar
authors.initials: T
authors.lastname: Nijsten
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D065626:Non-alcoholic Fatty Liver Disease; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D011565:Psoriasis / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution
keywords: comorbidity; liver disease; metabolic syndrome; nonalcoholic fatty liver disease; psoriasis