medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-045medsovet-8135Research ArticleЗАБОЛЕВАНИЯ КОЖИDERMAL DISEASESНеалкогольная жировая болезнь печени и псориаз: механизмы коморбидности и подходы к терапииNon-alcoholic fatty liver disease and psoriasis: mechanisms of comorbidity and approaches to therapyhttps://orcid.org/0000-0002-6581-7017ЛивзанМ. А.LivzanM. A.

Ливзан Мария Анатольевна - чл.-корр. РАН, д.м.н., профессор, заведующий кафедрой факультетской терапии и гастроэнтерологии, ректор.

644099, Омск, ул. Ленина, д. 12

Maria A. Livzan - Corr. Member RAS, Dr. Sci. (Med.), Professor, Head of the Department of Faculty Therapy and Gastroenterology, Omsk State Medical University.

1, Lenin St., Omsk, 644043

mlivzan@yandex.ruhttps://orcid.org/0000-0001-9370-4768ГаусО. В.GausO. V.

Гаус Ольга Владимировна - к.м.н., доцент, доцент кафедры факультетской терапии и гастроэнтерологии.

644099, Омск, ул. Ленина, д. 12

Olga V. Gaus - Cand. Sci. (Med.), Associate Professor, Associate Professor of the Department of Faculty Therapy and Gastroenterology, Omsk State Medical University.

12, Lenin St., Omsk, 644043

gaus_olga@bk.ruhttps://orcid.org/0000-0001-6233-3482ЕкимовИ. Н.EkimovI. N.

Екимов Илья Николаевич - ординатор кафедры дерматовенерологии и косметологии.

644099, Омск, ул. Ленина, д. 12

Ilya N. Ekimov - Resident of the Department of Dermatovenerology and Cosmetology, Omsk State Medical University.

12, Lenin St., Omsk, 644043

ekimov_ilia@mail.ruОмский государственный медицинский университетРоссияOmsk State Medical UniversityRussian Federation20240803202402113120Copyright © Ливзан М.А., Гаус О.В., Екимов И.Н., 20242024Ливзан М.А., Гаус О.В., Екимов И.Н.Livzan M.A., Gaus O.V., Ekimov I.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8135

Псориаз – хроническое иммуноопосредованное заболевание кожи мультифакториальной природы, характеризующееся ускоренной пролиферацией кератиноцитов и нарушением их дифференцировки, дисбалансом между провоспалительными и противовоспалительными цитокинами, с частым вовлечением в патологический процесс опорно-двигательного аппарата. Хотя точная этиология псориаза не установлена, было выявлено несколько факторов риска, включая семейный анамнез, курение и ожирение. Высокая распространенность у пациентов с псориазом ожирения, различных заболеваний сердечно-сосудистой системы и органов пищеварения позволяет рассматривать его в качестве индикатора имеющихся у пациента метаболических расстройств. В структуре коморбидности больных с псориазом особое внимание привлекает неалкогольная жировая болезнь печени (НАЖБП), которая занимает лидирующие позиции в структуре заболеваемости хроническими диффузными заболеваниями печени среди взрослого населения во многих странах мира, в том числе в России. Появившиеся в последние годы сведения демонстрируют, что у пациентов с псориазом чаще диагностируется НАЖБП независимо от наличия метаболического синдрома и других традиционных факторов риска, при этом наличие НАЖБП ассоциировано с более тяжелым течением и худшими исходами псориаза. С другой стороны, отмечено негативное влияние псориаза на течение патологии печени. В этой связи особо актуальным представляется изучение этиологических факторов и патогенетических звеньев, лежащих в основе данной коморбидности, как потенциальных мишеней для таргетной терапии, позволяющей повысить эффективность лечения данной когорты больных. Целью настоящей обзорной публикации является обобщение и систематизация имеющихся данных о распространенности в популяции коморбидности псориаза и НАЖБП, механизмах ее формирования и подходах к ведению пациентов.

Psoriasis is a chronic immune-mediated skin disease of a multifactorial nature, characterized by accelerated proliferation of keratinocytes and impaired differentiation, an imbalance between pro-inflammatory and anti-inflammatory cytokines, with frequent involvement of the musculoskeletal system in the pathological process. The etiology of psoriasis is unknown, but several risk factors have been identified, including family history, smoking and obesity. The high prevalence of obesity, diseases of the cardiovascular system and digestive organs in patients with psoriasis allows us to consider it as an indicator of the patient’s metabolic disorders. In the structure of comorbidity of patients with psoriasis, special attention is drawn to non-alcoholic fatty liver disease (NAFLD), which occupies a leading position in the structure of the incidence of chronic diffuse liver diseases among the adult population in many countries of the world, including Russia. Patients with psoriasis are more often diagnosed with NAFLD, regardless of the presence of metabolic syndrome and other traditional risk factors. The presence of NAFLD is associated with more severe psoriasis and worse outcomes. On the other hand, a negative effect of psoriasis on the course of liver pathology has been noted. In this regard, it seems particularly relevant to study the etiological factors and pathogenetic links underlying this comorbidity, as potential targets for targeted therapy, which can improve the effectiveness of treatment for this cohort of patients. The purpose of this review publication is to summarize and systematize the available data on the prevalence of comorbidity of psoriasis and NAFLD in the population, the mechanisms of its formation and approaches to patient management.

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The authors declare that there are no conflicts of interest present.