Prevalence of Metabolic-Dysfunction-Associated Steatotic Liver Disease in Patients with Psoriasis and Psoriatic Arthritis

Background/Objectives: Psoriatic disease (PsD) is a chronic cutaneous and systemic inflammatory condition associated with an increased risk of metabolic-dysfunction-associated steatotic liver disease (MASLD) and its complications. Our objective was to determine the prevalence of MASLD in our overall cohort and to analyze it across PsO, PsA, and healthy control groups. The secondary objective was to describe hepatic steatosis and fibrosis using transient elastography (FibroScan®) and to characterize hepatic scores within each study group. The third objective was to assess whether specific cardiovascular risk factors were associated with the development of hepatic steatosis or fibrosis in individuals with PsD and healthy controls. Methods: A cross-sectional study was conducted at a single tertiary care center, enrolling consecutive patients from the Dermatology and Rheumatology Departments. Individuals with pre-existing liver disorders were excluded. The control cohort comprised 102 healthy volunteers without chronic inflammatory or hepatic conditions. All participants underwent comprehensive clinical assessments, serum biomarker analysis, and FibroScan®. Results: A total of 330 participants were included, 228 with PsD (101 with psoriasis (PsO) and 127 with psoriatic arthritis (PsA)) and 102 healthy controls. MASLD was present in 39% of the overall cohort, with a prevalence of 47.5% in PsO, 32.2% in PsA, and 8.8% in healthy controls (p < 0.001). FibroScan® measurements indicated a tendency toward increased liver stiffness and higher controlled attenuation parameter (CAP) values in patients with PsD. Both PsO and PsA groups showed a higher prevalence of cardiometabolic risk factors compared with controls (p < 0.05). Non-invasive fibrosis indices were also significantly altered in both patient groups. Conclusions: Patients with PsD demonstrated a higher prevalence of MASLD, hepatic fibrosis, and cardiometabolic abnormalities compared with healthy controls in our cohort.