{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:29:29Z","timestamp":1791289769499,"version":"4.3.0"},"reference-count":47,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Psoriasis is a chronic immune-mediated skin disease associated with several metabolic comorbidities. Metabolic dysfunction-associated steatotic liver disease (MASLD) is also linked to psoriasis, but evidence regarding the severity of this association remains inconclusive. This meta-analysis aimed to investigate the relationship between MASLD and varying severities of psoriasis. Methods: We conducted an extensive search of four databases, MEDLINE, EMBASE, OSF, and ClinicalTrials.gov to identify relevant published articles assessing the risk of prevalent MASLD in patients with moderate-to-severe psoriasis up to April 2024. Effect estimates from each included study were combined together to calculate a pooled effect estimate for the meta-analysis using the generic inverse variance method of DerSimonian and Laird. Results: This meta-analysis included eight studies with a total of 109,806 participants. A 4.01-fold increased risk of prevalent MASLD was observed in patients with moderate-to-severe psoriasis compared to those without psoriasis (95% CI: 2.17, 7.77; I2 = 67%, p &lt; 0.0001). The evidence supporting this outcome had low certainty. Conclusions: An incremental trend of MASLD was observed in patients with moderate-to-severe psoriasis. Routine screening for MASLD should be emphasized in this population.<\/jats:p>","DOI":"10.3390\/jcm14041374","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T03:29:53Z","timestamp":1739935793000},"page":"1374","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The Risk of Metabolic Dysfunction-Associated Steatotic Liver Disease in Moderate-to-Severe Psoriasis: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8954-7824","authenticated-orcid":false,"given":"Suvijak","family":"Untaaveesup","sequence":"first","affiliation":[{"name":"Chao Khun Paiboon Hospital, Kanchanaburi 71140, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7890-8356","authenticated-orcid":false,"given":"Piyawat","family":"Kantagowit","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4817-9404","authenticated-orcid":false,"given":"Patompong","family":"Ungprasert","sequence":"additional","affiliation":[{"name":"Department of Rheumatic and Immunologic Diseases, Cleveland Clinic Foundation, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitchanan","family":"Kitlertbanchong","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5012-5164","authenticated-orcid":false,"given":"Tanyatorn","family":"Vajiraviroj","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1285-1175","authenticated-orcid":false,"given":"Tanpichcha","family":"Sutithavinkul","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1531-291X","authenticated-orcid":false,"given":"Gynna","family":"Techataweewan","sequence":"additional","affiliation":[{"name":"College of Integrative Medicine, Dhurakij Pundit University, Bangkok 10210, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2728-8968","authenticated-orcid":false,"given":"Wongsathorn","family":"Eiumtrakul","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rinrada","family":"Threethrong","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3408-7277","authenticated-orcid":false,"given":"Thanaboon","family":"Chaemsupaphan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1744-9309","authenticated-orcid":false,"given":"Walaiorn","family":"Pratchyapruit","sequence":"additional","affiliation":[{"name":"Institute of Dermatology, Ministry of Public Health, Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8294-8601","authenticated-orcid":false,"given":"Chutintorn","family":"Sriphrapradang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1038\/jid.2010.103","article-title":"Psoriasis and systemic inflammatory diseases: Potential mechanistic links between skin disease and co-morbid conditions","volume":"130","author":"Davidovici","year":"2010","journal-title":"J. Investig. Dermatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jaad.2016.07.064","article-title":"Psoriasis and comorbid diseases: Epidemiology","volume":"76","author":"Takeshita","year":"2017","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"adv00033","DOI":"10.2340\/00015555-3387","article-title":"Psoriasis and Co-morbidity","volume":"100","author":"Amin","year":"2020","journal-title":"Acta Derm. Venereol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1001\/jamadermatol.2021.2007","article-title":"Psoriasis Prevalence in Adults in the United States","volume":"157","author":"Armstrong","year":"2021","journal-title":"JAMA Dermatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.jaad.2008.10.062","article-title":"Trends in incidence of adult-onset psoriasis over three decades: A population-based study","volume":"60","author":"Icen","year":"2009","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1684\/ejd.2022.4245","article-title":"Global trends in the incidence of psoriasis from 1990 to 2019","volume":"32","author":"Mou","year":"2022","journal-title":"Eur. J. Dermatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/j.jid.2017.10.024","article-title":"Risk of Incident Liver Disease in Patients with Psoriasis, Psoriatic Arthritis, and Rheumatoid Arthritis: A Population-Based Study","volume":"138","author":"Ogdie","year":"2018","journal-title":"J. Investig. Dermatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.dsi.2018.06.006","article-title":"Health-related quality of life among patients with moderate-to-severe plaque psoriasis in Taiwan","volume":"36","author":"Tsai","year":"2018","journal-title":"Dermatol. Sin."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1016\/j.jhep.2009.04.020","article-title":"Non-alcoholic fatty liver disease in patients with chronic plaque psoriasis","volume":"51","author":"Gisondi","year":"2009","journal-title":"J. Hepatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1001\/jama.2020.4006","article-title":"Pathophysiology, Clinical Presentation, and Treatment of Psoriasis: A Review","volume":"323","author":"Armstrong","year":"2020","journal-title":"JAMA"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1016\/S0140-6736(14)61909-7","article-title":"Psoriasis","volume":"386","author":"Boehncke","year":"2015","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Bu, J., Ding, R., Zhou, L., Chen, X., and Shen, E. (2022). Epidemiology of Psoriasis and Comorbid Diseases: A Narrative Review. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.880201"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1111\/bjd.16239","article-title":"Nonalcoholic fatty liver disease in patients with psoriasis: A consequence of systemic inflammatory burden?","volume":"179","author":"Prussick","year":"2018","journal-title":"Br. J. Dermatol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Mantovani, A., Gisondi, P., Lonardo, A., and Targher, G. (2016). Relationship between Non-Alcoholic Fatty Liver Disease and Psoriasis: A Novel Hepato-Dermal Axis?. Int. J. Mol. Sci., 17.","DOI":"10.3390\/ijms17020217"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1136\/gutjnl-2020-322572","article-title":"Non-alcoholic fatty liver disease and risk of incident diabetes mellitus: An updated meta-analysis of 501 022 adult individuals","volume":"70","author":"Mantovani","year":"2021","journal-title":"Gut"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"4753","DOI":"10.1210\/jc.2006-0587","article-title":"Review: The role of insulin resistance in nonalcoholic fatty liver disease","volume":"91","author":"Utzschneider","year":"2006","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1002\/hep.29367","article-title":"The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases","volume":"67","author":"Chalasani","year":"2018","journal-title":"Hepatology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1111\/jdv.12847","article-title":"Risk of non-alcoholic fatty liver disease in patients with psoriasis: A systematic review and meta-analysis","volume":"29","author":"Candia","year":"2015","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1007\/s40618-022-01755-0","article-title":"Risk of non-alcoholic fatty liver disease in patients with chronic plaque psoriasis: An updated systematic review and meta-analysis of observational studies","volume":"45","author":"Bellinato","year":"2022","journal-title":"J. Endocrinol. Investig."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"b2535","DOI":"10.1136\/bmj.b2535","article-title":"Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement","volume":"339","author":"Moher","year":"2009","journal-title":"BMJ"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Untaaveesup, S., Kantagowit, P., Ungprasert, P., Kitlertbanchong, N., Vajiraviroj, T., Sutithavinkul, T., Techataweewan, G., Eiumtrakul, W., Threethrong, R., and Chaemsupaphan, T. (2025). The Risk of Metabolic Dysfunction-Associated Steatotic Liver Disease in Moderate-to-Severe Psoriasis: A systematic review and meta-analysis. INPLASY.","DOI":"10.37766\/inplasy2025.1.0068"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00403-010-1080-1","article-title":"Definition of treatment goals for moderate to severe psoriasis: A European consensus","volume":"303","author":"Mrowietz","year":"2011","journal-title":"Arch. Dermatol. Res."},{"key":"ref_23","unstructured":"World Health Organization (2019). International Statistical Classification of Diseases and Related Health Problems, 10th revision, World Health Organization. Available online: https:\/\/icd.who.int\/browse10\/2019\/en."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Naslund-Koch, C., Bojesen, S.E., Gluud, L.L., Skov, L., and Vedel-Krogh, S. (2022). Non-alcoholic fatty liver disease is not a causal risk factor for psoriasis: A Mendelian randomization study of 108,835 individuals. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.1022460"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"67","DOI":"10.4103\/ejdv.ejdv_15_22","article-title":"Systemic comorbidities in patients of psoriasis: A case\u2013control study from India","volume":"43","author":"Chavhan","year":"2023","journal-title":"Egypt. J. Dermatol. Venerol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1093\/ced\/llac028","article-title":"Cross-sectional study to estimate the prevalence and risk factors of nonalcoholic fatty liver disease in children and adolescents with psoriasis","volume":"48","author":"Panjiyar","year":"2023","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"377","DOI":"10.4103\/ijd.ijd_1015_22","article-title":"Interleukin Levels and Non-Alcoholic Fatty Liver Disease in Chronic Plaque Psoriasis: An Analytical Case Control Study","volume":"68","author":"Yadav","year":"2023","journal-title":"Indian. J. Dermatol."},{"key":"ref_28","first-page":"33","article-title":"A Case-control Study to Evaluate the Prevalence of Nonalcoholic Fatty Liver Disease Among Patients with Moderate-to-severe Psoriasis","volume":"11","author":"Awosika","year":"2018","journal-title":"J. Clin. Aesthet. Dermatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/j.jceh.2021.11.016","article-title":"The Association Between Chronic Plaque Psoriasis and Nonalcoholic Fatty Liver Disease in Indian Patients: Results of a Pilot Study","volume":"12","author":"Mahajan","year":"2022","journal-title":"J. Clin. Exp. Hepatol."},{"key":"ref_30","first-page":"45","article-title":"A study on prevalence of non alcoholic fatty liver disease (NAFLD) in moderate to severe psoriasis and its relation to abdominal obesity and insulin resistance","volume":"30","author":"Basireddy","year":"2016","journal-title":"JEADV"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Herzog, R., \u00c1lvarez-Pasquin, M.J., D\u00edaz, C., Del Barrio, J.L., Estrada, J.M., and Gil, \u00c1. (2013). Are healthcare workers\u2019 intentions to vaccinate related to their knowledge, beliefs and attitudes? a systematic review. BMC Public. Health, 13.","DOI":"10.1186\/1471-2458-13-154"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/j.bja.2019.08.015","article-title":"Use of the GRADE approach in systematic reviews and guidelines","volume":"123","author":"Granholm","year":"2019","journal-title":"Br. J. Anaesth."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/0197-2456(86)90046-2","article-title":"Meta-analysis in clinical trials","volume":"7","author":"DerSimonian","year":"1986","journal-title":"Control Clin. Trials"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.cca.2008.04.005","article-title":"Cytokines and anticytokines in psoriasis","volume":"394","author":"Pietrzak","year":"2008","journal-title":"Clin. Chim. Acta"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Plenkowska, J., Gabig-Ciminska, M., and Mozolewski, P. (2020). Oxidative Stress as an Important Contributor to the Pathogenesis of Psoriasis. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21176206"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"120","DOI":"10.4330\/wjc.v8.i2.120","article-title":"Psoriasis, non-alcoholic fatty liver disease, and cardiovascular disease: Three different diseases on a unique background","volume":"8","author":"Ganzetti","year":"2016","journal-title":"World J. Cardiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.freeradbiomed.2020.02.025","article-title":"Role of oxidative stress in the pathogenesis of nonalcoholic fatty liver disease","volume":"152","author":"Chen","year":"2020","journal-title":"Free Radic. Biol. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1001\/jamadermatol.2022.1609","article-title":"Association Between Psoriasis and Nonalcoholic Fatty Liver Disease Among Outpatient US Adults","volume":"158","author":"Ruan","year":"2022","journal-title":"JAMA Dermatol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1111\/j.1468-3083.2010.03841.x","article-title":"Psoriasis and non-alcoholic fatty liver disease","volume":"25","author":"Wenk","year":"2011","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1111\/j.1365-2133.2011.10539.x","article-title":"Correlation between lipoprotein(a) and lipid peroxidation in psoriasis: Role of the enzyme paraoxonase-1","volume":"166","author":"Ferretti","year":"2012","journal-title":"Br. J. Dermatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1001\/jamadermatol.2017.0499","article-title":"Pediatric Psoriasis Comorbidity Screening Guidelines","volume":"153","author":"Osier","year":"2017","journal-title":"JAMA Dermatol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1016\/j.jaad.2018.11.058","article-title":"Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities","volume":"80","author":"Elmets","year":"2019","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1111\/jdv.12024","article-title":"Clinical practice guideline for an integrated approach to comorbidity in patients with psoriasis","volume":"27","author":"Dauden","year":"2013","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_45","unstructured":"European Association for the Study of the Liver, European Association for the Study of Diabetes, and European Association for the Study of Obesity (2024). EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J. Hepatol., 81, 492\u2013542."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1097\/HEP.0000000000000323","article-title":"AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease","volume":"77","author":"Rinella","year":"2023","journal-title":"Hepatology"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/4\/1374\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:37:29Z","timestamp":1760027849000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/4\/1374"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,19]]},"references-count":47,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["jcm14041374"],"URL":"https:\/\/doi.org\/10.3390\/jcm14041374","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,19]]}}}