Hidradenitis Suppurativa is Associated with Non-alcoholic Fatty Liver Disease: A Cross-sectional Study
Iris González-Villanueva, Cristina DeGracia, Mariana Planells, Inés Poveda, Pedro Álvarez, Luca Schneller-Pavalescu, Isabel Betlloch, Gregor B.E. Jemec, Jose M. Ramos, Jose C. Pascual
Non-alcoholic fatty liver disease (NAFLD) is currently the most common cause of end-stage liver disease. The aim of this controlled cross-sectional study was to assess the association between NAFLD and hidradenitis suppurativa. NAFLD was assessed using hepatic ultrasound. A total of 125 patients with hidradenitis suppurativa and 120 patients without hidradenitis suppurativa were recruited, matched for age, sex and body mass index (< 25 or ≥ 25 kg/m2), a risk factor related to NAFLD. Both groups presented similar proportions of overweight or obesity (89.6% vs 90%). Patients with hidradenitis suppurativa presented significantly higher prevalence of NAFLD compared with those with non- hidradenitis suppurativa (57.6% vs 31.7%, p < 0.001). Multivariable analysis confirmed independent association between hidradenitis suppurativa and NAFLD (odds ratio 2.79, 95% confidence interval 1.48–5.25; p = 0.001) besides age, body mass index, hypertension and hypertransaminasaemia. Hidradenitis suppurativa is significantly associated with the development of NALFD regardless of the presence of classic metabolic risk factors.
Non-alcoholic fatty liver disease has been linked with chronic inflammatory conditions, such as psoriasis. Hidradenitis suppurativa shares key pathogenic features and comorbidities with psoriasis, and this study shows that it is also an independent risk factor for non-alcoholic fatty liver disease. Clinicians should consider routine work-up for non-alcoholic fatty liver disease in patients with hidradenitis suppurativa.