A Case Control Study Evaluating the Prevalence of Non-Alcoholic Fatty Liver Disease Among Patients With Psoriasis
Condition: Psoriasis; Nonalcoholic Fatty Liver Disease
MeSH terms: Liver Diseases; Fatty Liver; Non-alcoholic Fatty Liver Disease; Psoriasis
Study type: Observational

Summary: 
      Main objectives

      1. Establish the association of psoriasis and the presence of NAFLD in the patients with
      psoriasis attending dermatologic clinic center.

      Secondary objective

        1. Evaluate for the presence of other components metabolic syndrome in this group of
           patients including hypercholesterolemia, hypertension, obesity, and insulin resistance

        2. Determine if there is an association between the extent and severity of psoriasis and
           the presence of NAFLD.

        3. Identify an association between BMI and presence of NAFLD in people with psoriasis and
           use it as a predictive index for primary screening of NAFLD in psoriatic patients.
    

Detailed description: 
      Psoriasis is a common inflammatory disorder of the skin and in some patients the joints.
      Several reports have demonstrated a possible association between psoriasis and diabetes
      mellitus, obesity, hypertension, myocardial infarction, and heart failure.

      Metabolic syndrome (MS) is a cluster of diabetes mellitus, hypertension, visceral obesity and
      hyperlipidemia and is thought to be caused by insulin resistance and the presence of a
      systemic inflammation which is evident by the increased level of inflammatory cytokines like
      TNF in this group of patients.

      Non Alcoholic Fatty Liver Disease ( NAFLD) is the accumulation of fat vacuoles in the
      cytoplasm of hepatocytes and is believed to be the most common cause of chronic liver disease
      in developed countries. Currently, the metabolic syndrome has been found to be a strong
      predictor of NAFLD, and NAFLD is widely accepted to be the hepatic manifestation of the MS.

      Since people with psoriasis have significantly higher rates of metabolic syndrome and
      regarding the fact that NAFLD is considered as the hepatic manifestation of MS, the purpose
      of this study is to determine the prevalence of NAFLD in subjects with psoriasis compared to
      the non -psoriatic population.

      We have designed a case control study of patients who attend the dermatologic clinic at GWU
      with a clinical diagnosis of psoriasis. By performing a limited RUQ abdominal ultrasonography
      at the GWU hospital, we will be able to screen the patients with a possible diagnosis of
      NAFLD. Since NAFLD is a diagnosis of exclusion, those patients who have been screened
      positive for NAFLD, will be further evaluated for ruling out the other etiologies of fatty
      liver such as alcohol abuse and hepatitis.
    

Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Patients will be selected from the Dermatology Clinic at George Washington University
        Hospital, Medical Faculty Associates.
      
Keywords: psoriasis; fatty liver; metabolic syndrome