title: Liver Stiffness Measurement in Psoriasis: Do Metabolic or Disease Factors Play the Important Role?
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/m(2). 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.
  
  
  CONCLUSIONS
  11% of psoriatic patients had significant liver fibrosis by high LSM. Waist circumference, diabetes, and AST level were the independent predictors.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Jamrus
authors.initials: J
authors.lastname: Pongpit
authors.affiliation: Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Saneerat
authors.initials: S
authors.lastname: Porntharukchareon
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Piyaporn
authors.initials: P
authors.lastname: Kaewduang
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Kwannapa
authors.initials: K
authors.lastname: Promson
authors.affiliation: Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Wasana
authors.initials: W
authors.lastname: Stitchantrakul
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Supanna
authors.initials: S
authors.lastname: Petraksa
authors.affiliation: Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Ammarin
authors.initials: A
authors.lastname: Thakkinstian
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Chomsri
authors.initials: C
authors.lastname: Kositchaiwat
authors.affiliation: Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Natta
authors.initials: N
authors.lastname: Rajatanavin
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
authors.forename: Abhasnee
authors.initials: A
authors.lastname: Sobhonslidsuk
mesh_terms: D000328:Adult; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000378:metabolism; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000378:metabolism; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000378:metabolism; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000145:classification / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000378:metabolism; D015995:Prevalence; D011565:Psoriasis / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000378:metabolism