A recent study found no significant association between moderate-to-severe atopic dermatitis and the incidence of non-alcoholic fatty liver disease.
Atopic dermatitis (AD) is an inflammatory skin disease affecting approximately 20% of children and 2–8% of adults. Some studies have linked AD to metabolic syndrome. As metabolic syndrome is associated with non-alcoholic fatty liver disease (NAFLD), an association between AD and NAFLD is possible; however, there is a lack of evidence.
A study in the Journal of Clinical Medicine has assessed the prevalence of NAFLD in adults with moderate-to-severe AD.
The study comprised 144 adult patients with moderate-to-severe AD, 466 patients with chronic plaque psoriasis, and 99 patients with in situ melanoma. Male sex, age, and body mass index (BMI) were significantly higher in chronic plaque psoriasis patients than in melanoma or AD patients. Psoriasis patients were also more likely to have type-2 diabetes and obesity, with higher fasting glucose and triglyceride levels than the other two groups.
High Prevalence of Non-Alcoholic Fatty Liver Disease in Psoriasis Compared to Atopic Dermatitis and Melanoma
The prevalence of NAFLD (detected through ultrasonography) was substantially higher in patients with chronic plaque psoriasis than in patients with AD or in situ melanoma (49.8% vs. 24.1% vs. 23.2%, respectively; p<0.01). The prevalence of NAFLD in adult patients with moderate-to-severe AD was similar to that observed in patients with melanoma in situ (taken as the control group). The results were unchanged even after restricting the analysis to patients older than 50 years. The ultrasound-detected NAFLD prevalence in this case was 69.4% vs. 42.8% vs. 42.1% in patients with psoriasis, in situ melanoma, and AD, respectively (p<0.01).
Psoriasis Group Showed Higher Liver Fibrosis Markers
Regarding the non-invasive markers of hepatic fibrosis, the psoriasis group had a significantly higher AST-to-ALT ratio and a greater proportion of individuals with fibrosis (FIB)-4 index scores ≥1.3 or a BARD score ≥2 (indicating advanced fibrosis). These non-invasive markers of advanced liver fibrosis were similar between patients with AD and those with in situ melanoma.
No Significant Link Between Moderate-to-Severe Atopic Dermatitis and Non-Alcoholic Fatty Liver Disease
Logistic regression analysis showed that male sex, higher age, higher BMI, and the presence of chronic plaque psoriasis were independently associated with NAFLD. In contrast, AD was not significantly associated with NAFLD after adjusting for age, sex, BMI, and type-2 diabetes (adjusted odds ratio 1.02, 95% confidence interval 0.78–1.26).
In conclusion, no significant association between moderate-to-severe AD and NAFLD was found. However, further, larger-scale studies are needed to corroborate these findings.
Maurelli, M., Gisondi, P., Bellinato, F., Mantovani, A., Targher, G., & Girolomoni, G. (2023). Prevalence of Non-Alcoholic Fatty Liver Disease in Adult Individuals with Moderate-to-Severe Atopic Dermatitis. Journal of Clinical Medicine, 12(18), 6057. https://doi.org/10.3390/jcm12186057