High Prevalence of NAFLD in Patients With Hidradenitis Suppurativa

A new study provides the first evidence that patients with HS have a significantly high prevalence of non-alcoholic fatty liver disease.

A high proportion of patients with hidradenitis suppurativa (HS) also have non-alcoholic fatty liver disease (NAFLD), with increased abdominal perimeter representing an increased risk for NAFLD in this patient population. This is according to a study in the Journal of the European Academy of Dermatology and Venereology.

In the case-control study, patients with HS (n=86) and age- and gender-matched controls (n=150) were recruited from a hospital in Spain. Each patient with HS and matched control underwent body height and weight, body mass index, and abdominal circumference measurements at baseline. Immunoradiometric assay was used to measure serum insulin, and insulin resistance was assessed using the homeostasis model assessment. The presence of sonographic characteristics of hepatic steatosis and/or altered transient elastography Controlled Attenuation Parameter was used to establish a clinical diagnosis of NAFLD.

Examinations demonstrated a higher prevalence of NAFLD in patients with HS vs controls (72.9% vs 24.7%, respectively; P <.001). Compared with patients with HS and without NAFLD, those with HS and NAFLD were more often obese (body mass index >30: mean, 2 vs 34, respectively; P <.001), had higher abdominal perimeter as a marker of central adiposity (mean, 82.47 cm vs 102.37 cm, respectively; P <.001), and fulfilled in a higher proportion of metabolic syndrome criteria (5.3% vs 49.0%, respectively; P <.001). Patients with HS and NAFLD had higher levels of liver stiffness measurement compared with controls with NAFLD (6.8±5.5 vs 4.9±1.9 KPa, respectively; P =.03). The multivariable regression analysis found an independent association between HS and the presence of NAFLD (odds ratio, 7.75; CI, 2.54-23.64; P <.001).

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Limitations of the study include its cross-sectional design as well as the relatively small sample size of the final cohort.

The researchers suggest that “the persistent systemic inflammation may be crucial to explain the premature and accelerated liver steatosis in” HS.

Disclosure: None of the study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

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Durán-Vian C, Arias-Loste MT, Hernández JL, et al. High prevalence of non-alcoholic fatty liver disease among hidradenitis suppurativa patients independent of classic metabolic risk factors [published online July 1, 2019]. J Eur Acad Dermatol Venereol. doi:10.1111/jdv.15764