Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov 29;24(23):16898.
doi: 10.3390/ijms242316898.

Predictive Performances of Blood-Count-Derived Inflammatory Markers for Liver Fibrosis Severity in Psoriasis Vulgaris

Oana Mirela Tiucă  1   2   3 , Silviu Horia Morariu  2   3 , Claudia Raluca Mariean  1   4 , Robert Aurelian Tiucă  1   5   6 , Alin Codrut Nicolescu  7 , Ovidiu Simion Cotoi  4   8
Affiliations

Predictive Performances of Blood-Count-Derived Inflammatory Markers for Liver Fibrosis Severity in Psoriasis Vulgaris

Oana Mirela Tiucă et al. Int J Mol Sci. .

Abstract

Psoriasis is an immune-mediated, chronic disorder that significantly alters patients' quality of life and predisposes them to a higher risk of comorbidities, including liver fibrosis. Various non-invasive tests (NITs) have been validated to assess liver fibrosis severity, while blood-count-derived inflammatory markers have been proven to be reliable in reflecting inflammatory status in psoriatic disease. The fibrosis-4 (FIB-4) index became part of the newest guideline for monitoring psoriasis patients undergoing systemic treatment. Patients with psoriasis vulgaris and fulfilling inclusion criteria were enrolled in this study, aiming to assess for the first time in the literature whether such inflammatory markers are useful in predicting liver fibrosis. Based on internationally validated FIB-4 index values, patients were divided into two study groups: a low risk of significant fibrosis (LR-SF) and a high risk of significant fibrosis (HR-SF). Patients from HR-SF were significantly older and had higher values of the monocyte-to-lymphocyte ratio (MLR) (p < 0.001), which further significantly correlated with fibrosis severity (p < 0.001). Platelet-to-lymphocyte ratio (PLR), systemic immune inflammation index (SII), platelet-to-white blood cell ratio (PWR), and aggregate index of systemic inflammations (AISI) significantly correlated negatively with liver fibrosis (p < 0.001). PWR proved to be the most reliable inflammatory predictor of fibrosis severity (AUC = 0.657). MLR, PWR, and AISI were independent inflammatory markers in multivariate analysis (p < 0.001), while the AST to platelet ratio index (APRI) and AST to ALT ratio (AAR) can be used as additional NITs for significant liver fibrosis (p < 0.001). In limited-resources settings, blood-count-derived inflammatory markers such as MLR, PWR, and AISI, respectively, and hepatic indexes APRI and AAR prove to be of particular help in predicting significant liver fibrosis.

Keywords: fibrosis; inflammation; non-invasive; psoriasis; risk-assessment.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
ROC comparison of PLR, MLR, AISI, SII, and PWR in predicting significant liver fibrosis.
Figure 2
Figure 2
ROC comparison of APRI, AAR, and GPR for predicting significant liver fibrosis.
See this image and copyright information in PMC

References

    1. Damiani G., Bragazzi N.L., Karimkhani Aksut C., Wu D., Alicandro G., McGonagle D., Guo C., Dellavalle R., Grada A., Wong P., et al. The Global, Regional, and National Burden of Psoriasis: Results and Insights from the Global Burden of Disease 2019 Study. Front. Med. 2021;8:743180. doi: 10.3389/fmed.2021.743180. - DOI - PMC - PubMed
    1. Nicolescu A.C., Bucur Ș., Giurcăneanu C., Gheucă-Solovăstru L., Constantin T., Furtunescu F., Ancuța I., Constantin M.M. Prevalence and Characteristics of Psoriasis in Romania—First Study in Overall Population. J. Pers. Med. 2021;11:523. doi: 10.3390/jpm11060523. - DOI - PMC - PubMed
    1. Armstrong A.W., Harskamp C.T., Armstrong E.J. The association between psoriasis and hypertension: A systematic review and meta-analysis of observational studies. J. Hypertens. 2013;31:433–443. doi: 10.1097/HJH.0b013e32835bcce1. - DOI - PubMed
    1. Friedland R., Kridin K., Cohen A.D., Landau D., Ben-Amitai D. Psoriasis and Renal Disorders: A Large-Scale Population-Based Study in Children and Adults. Dermatology. 2022;238:904–909. doi: 10.1159/000522228. - DOI - PMC - PubMed
    1. Ogdie A., Grewal S.K., Noe M.H., Shin D.B., Takeshita J., Chiesa Fuxench Z.C., Carr R.M., Gelfand J.M. Risk of Incident Liver Disease in Patients with Psoriasis, Psoriatic Arthritis, and Rheumatoid Arthritis: A Population-Based Study. J. Investig. Dermatol. 2018;138:760–767. doi: 10.1016/j.jid.2017.10.024. - DOI - PMC - PubMed