Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is characterized by hepatic steatosis and subsequent fibrosis associated with metabolic abnormalities such as insulin resistance, dyslipidemia, obesity, hypertension, and atherosclerosis. It is closely associated with an increased cardiovascular (CV) risk, independent of traditional CV risk factors and metabolic syndrome features. Psoriatic Arthritis (PsA) and NAFLD share similar underlying inflammatory pathways, cells, and pro-inflammatory cytokines. The Fibrosis-4 Index (FIB-4) is an economical and practical calculator for assessing fibrosis in NAFLD. The effect of NAFLD fibrosis on cardiovascular risk in the context of psoriatic arthritis has not been established.

Objectives: To compare disease activity, cardiovascular risk, and prevalence of carotid plaque (CP) and increased carotid intima-media thickness (cIMT) in patients with liver fibrosis stage 0-1 vs. fibrosis stage ≥2 measured by FIB-4.

Methods: We performed an observational, comparative, and cross-sectional study in patients who fulfilled the 2006 Classification Criteria for Psoriatic Arthritis (CASPAR). Patients with a history of prior atherosclerotic CV disease and pregnancy were excluded. Disease activity was measured by Disease Activity for Psoriatic Arthritis Score (DAPSA), Psoriasis Severity Index (PASI), and Nail Psoriasis Severity Index (NAPSI). Cardiovascular risk was estimated by the QRISK3 calculator. FIB-4 score was calculated as (Age* x AST)/ (Platelets x √(ALT ). The prevalence of CP and increased cIMT was determined by Carotid B-mode ultrasonography. Descriptive analyses were performed with frequencies (%), mean (± SD), and median (p25-p75), and comparisons with Chi-square, Student ́s t, and Mann-Whitney U test. We considered p<0.05 significant.

Results: We recruited 86 patients who fulfilled the criteria. The prevalence for NAFLD fibrosis stage ≥2 was 26.74%. We found no significant difference between the groups in the disease activity criteria or statin use. Patients with a higher NAFLD stage were older [60.21 ±9.45 vs. 53.61 ±9.67; p=0.006] and had a higher prevalence of hypertension [13 (56.52%) vs. 19 (30.15%); p=0.025]. We found no other significant differences among the comorbidities between groups. Patients with a FIB-4 in stage ≥ 2 had higher CV risk [13.20 (1.7- 46.10) vs. 7.43 (0.3-36.50); p=0.010]. There were no differences between groups in the prevalence of carotid plaque [7 (30.43%) vs. 19 (30.15%); p= NS] or increased cIMT [1 (4.34%) vs. 7 (11.11%); p=NS]. (Table 1)

Conclusion: NAFLD and liver fibrosis are associated with an increased CV risk and atherosclerosis. In our population, patients with stage ≥2 NAFLD measured by FIB-4 had an increased CV risk without significant differences in the prevalence of CP or increased cIMT.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: None declared.