This study investigated the underlying drivers of fatty liver disease (FLD) in patients with psoriasis, specifically examining whether insulin resistance (IR) or systemic inflammation is more closely associated. Using data from 647 individuals in the Shanghai Psoriasis Effectiveness Evaluation Cohort, researchers assessed IR through triglyceride glucose (TyG) and TyG-body mass index (TyG-BMI) indicators, while inflammation was measured using NLR, dNLR, and SII. The goal was to determine which of these factors more strongly correlates with FLD in the psoriasis population.

Results showed that markers of systemic inflammation were not significantly associated with FLD, while both TyG and TyG-BMI—particularly TyG-BMI—were consistently linked to the presence of FLD across various subgroups. These associations held even after excluding patients using medications like methotrexate and acitretin. Additionally, the diagnosis rate of metabolic-associated fatty liver disease (MAFLD) was significantly higher than that of NAFLD, suggesting that metabolic dysfunction, rather than inflammation, is the primary driver of FLD in psoriasis. As such, the study recommends using the term MAFLD for more accurate classification in this patient population.

Reference: Zhong X, Huang D, Chen R, et al. Positive association between insulin resistance and fatty liver disease in psoriasis: evidence from a cross-sectional study. Front Immunol. 2024 Apr 23;15:1388967. doi: 10.3389/fimmu.2024.1388967. PMID: 38715604; PMCID: PMC11074461.