Psoriasis is independently associated with nonalcoholic fatty liver disease in patients 55 years old or older: Results from a population-based study

Published:December 26, 2013DOI:


      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.


      We sought to compare the prevalence of NAFLD in people with psoriasis and those without psoriasis.


      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.


      In total, 2292 participants were included (mean age 76.2 ± 6.0 years; 58.7% female; mean body mass index 27.4 ± 4.2kg/m2) 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).


      This was a cross-sectional study.


      Elderly participants with psoriasis are 70% more likely to have NAFLD than those without psoriasis independent of common NAFLD risk factors.

      Key words

      Abbreviations used:

      ALT (alanine aminotransferase), BMI (body mass index), CI (confidence interval), NAFLD (nonalcoholic fatty liver disease), OR (odds ratio), PASI (Psoriasis Area Severity Index)
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      Linked Article

      • Psoriasis or obesity is a risk factor for nonalcoholic fatty liver disease
        Journal of the American Academy of DermatologyVol. 71Issue 3
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          To the Editor: We read with interest the article by van der Voort et al: “Psoriasis is independently associated with nonalcoholic fatty liver disease in patients 55 years old or older: Results from a population-based study.”1 Their large prospective population-based cohort study (part of Rotterdam study) enrolled elderly participants (>55 years) using validated methods for the diagnosis of fatty liver disease by abdominal ultrasonography in the absence of other diseases. Indeed, the authors demonstrated that the prevalence of non-alcoholic fatty liver disease was 46.2% in psoriasis patients compared with 33.3% in the reference group without psoriasis (P = .005).
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