Low Serum Adiponectin May Identify MASLD as a Comorbidity in Patients with Moderate-to-Severe Psoriasis

Psoriasis is an independent risk factor for metabolic dysfunction-associated steatotic liver disease (MASLD), a condition that frequently remains undetected in clinical routine diagnostics. We investigated whether routine laboratory parameters as well as serum adipokines and cytokines differ between psoriasis patients with and without concurrent MASLD.

In this single-center retrospective study, patients with moderate-to-severe plaque psoriasis hospitalized between 2015 and 2024 were analyzed. MASLD was defined as hepatic steatosis (imaging and/or medical records) in conjunction with at least one cardiometabolic risk factor, after exclusion of other liver disease and harmful alcohol use. Serum adipokines and cytokines were quantified by bead-based multiplex assays. Groups were compared by Mann-Whitney U and Fisher exact tests; associations were assessed by Spearman correlation and BMI-adjusted multiple linear regression.

Forty-two psoriasis patients with MASLD (MASLD +) were compared with 17 without (MASLD -). MASLD + patients showed higher BMI (median 32.9 vs 26.7 kg/m², p=0.005), serum ALT (p=0.049), total cholesterol (p=0.007), LDL cholesterol (p=0.023), and CRP (p=0.038), and suffered more frequently from dyslipidemia (p=0.028). Serum adiponectin was significantly lower in MASLD + patients (12.3 vs 22.1 µg/mL, p=0.042), whereas leptin, resistin, adipsin, and all cytokines analyzed did not differ. Adiponectin inversely correlated with BMI (ρ=-0.29, p=0.046); after adjustment for BMI, the group difference was attenuated.

In moderate-to-severe psoriasis, concurrent MASLD is characterized by a metabolically adverse profile and reduced serum adiponectin. As the difference is partly explained by BMI, adiponectin warrants prospective evaluation as a candidate marker of concurrent MASLD.