Case Control Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 14, 2015; 21(22): 6892-6897
Published online Jun 14, 2015. doi: 10.3748/wjg.v21.i22.6892
Nonalcoholic fatty liver disease, spleen and psoriasis: New aspects of low-grade chronic inflammation
Nicola Balato, Maddalena Napolitano, Fabio Ayala, Cataldo Patruno, Matteo Megna, Giovanni Tarantino
Nicola Balato, Maddalena Napolitano, Fabio Ayala, Cataldo Patruno, Matteo Megna, Department of Dermatology, Federico II University of Naples, Naples 80131, Italy
Giovanni Tarantino, Department of Clinical Medicine and Surgery, Medical School, Federico II University of Naples, Naples 80131, Italy
Giovanni Tarantino, National Cancer Institute “Pascale Foundation, ” IRCS, Mercogliano (AV) 83013, Italy
Author contributions: Balato N, Tarantino G, and Ayala F designed the research; Tarantino G, Megna M, and Napolitano M performed the research; Tarantino G and Napolitano M analyzed the data; and Napolitano M, Patruno C, and Tarantino G wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Giovanni Tarantino, MD, Department of Clinical Medicine and Surgery, Medical School, Federico II University of Naples, 5 Via Sergio Pansini, Naples 80131, Italy. giovanni.tarantino5@me.com
Telephone: +39-81-7462024 Fax: +39-81- 5466152
Received: July 8, 2014
Peer-review started: July 9, 2014
First decision: August 6, 2014
Revised: September 23, 2014
Accepted: December 14, 2014
Article in press: December 16, 2014
Published online: June 14, 2015
Processing time: 344 Days and 19.9 Hours
Abstract

AIM: To investigate spleen status in psoriasis and its relationship with hepatic steatosis, Psoriasis Area and Severity Index, and insulin resistance.

METHODS: Seventy-nine psoriatic patients who were not suffering from any chronic inflammatory disease were retrospectively selected for inclusion in this study, and their complete medical records were accessed. An age- and sex-matched group of 80 non-psoriatic, obese patients was included as a control. The following relevant data were collected: age, sex, weight, height, body mass index, waist circumference, blood pressure, insulin resistance status, age at psoriasis onset, and severity of psoriasis. Abdominal ultrasonography was performed to determine spleen longitudinal diameter (SLD), and hepatic steatosis grade.

RESULTS: The SLD of control obese patients was greater than that of psoriatic subjects (P = 0.013), but body mass index predicted the size of the spleen in psoriatic patients (P < 0.001). The SLD of psoriatic patients with normal weight was significantly reduced with respect to the overweight/obese psoriatic patients (P = 0.002). A multiple regression analysis revealed that body mass index was a unique predictor of the spleen size (P < 0.001). Finally, the disease duration predicted the spleen size in psoriatic subjects (P = 0.038).

CONCLUSION: This study shows a correlation between the SLD and the duration of psoriasis.

Keywords: Hepatic steatosis; Inflammation; Nonalcoholic fatty liver disease; Psoriasis; Spleen size

Core tip: The specific role of the spleen in psoriatics could help in more comprehensively understanding the inflammatory mechanism underlying this illness; psoriasis would be the most superficial manifestation of a chronic inflammatory process involving various organs and systems. The increased diameter of the spleen found in psoriatic patients with long-term illness may be the expression of the immune system’s response to the state of chronic inflammation.