Hemoglobin A1c is Associated With Advanced Liver Fibrosis in Psoriasis Patients With Metabolic Dysfunction‐Associated Steatotic Liver Disease

Psoriasis is a systemic inflammatory disease that is frequently accompanied by metabolic dysfunction-associated steatotic liver disease (MASLD) and is associated with an increased risk of liver fibrosis. Identifying psoriasis patients with MASLD at high risk of advanced liver fibrosis is clinically important; however, readily applicable markers in routine dermatological practice remain limited. Serum mac-2-binding protein glycosylation isomer (M2BPGi) level is a noninvasive and specific marker for assessing the degree of liver fibrosis, but its clinical utility in psoriasis patients with concomitant MASLD has not been fully elucidated. This single-center retrospective cross-sectional study aimed to investigate factors associated with advanced liver fibrosis in psoriasis patients with MASLD. Advanced liver fibrosis was defined as an M2BPGi level ≥ 0.78, and patients were classified into two groups: an M2BPGi < 0.78 group and an M2BPGi ≥ 0.78 group. Clinical characteristics and laboratory parameters were compared between groups, and univariate and multivariable logistic regression analyses were performed. In addition, multivariable receiver operating characteristic (ROC) curve analysis was conducted to evaluate the discriminatory performance of relevant factors. Patients with M2BPGi ≥ 0.78 were more likely to be female and had significantly higher hemoglobin A1c (HbA1c) levels. In multivariable logistic regression analysis, HbA1c remained independently associated with advanced liver fibrosis. A multivariable ROC model incorporating HbA1c, age, and body mass index demonstrated good discriminatory performance, with an area under the curve of 0.829. In conclusion, elevated HbA1c was independently associated with advanced liver fibrosis in psoriasis patients with MASLD. HbA1c may serve as a simple and potentially useful screening marker for identifying patients at high risk of advanced liver fibrosis in routine clinical practice.