A significant positive correlation was identified between elevated levels of non-high-density lipoprotein (non-HDL) cholesterol and HDL cholesterol ratio (NHHR) and an increased risk of psoriasis among American adults.¹ These results highlight the potential role of NHHR in the early assessment of psoriasis risk, providing a valuable tool for clinicians in the management of patients at higher risk.

The analysis demonstrated a positive correlation between psoriasis and NHHR. For each unit increase in NHHR, the risk of psoriasis increased by 7%. | Image credit: Kudryavtsev – stock.adobe.com

In this cross-sectional analysis, published in Clinical, cosmetic and experimental dermatology, the researchers aimed to examine the relationship between NHHR and psoriasis.

“Across subgroups based on race, diabetes, smoking, and sex, this association remained consistent,” they wrote. “According to the results, NHHR is crucial for the early diagnosis of psoriasis in people at high risk.”

The NHHR constitutes a new lipid parameter used to assess the risk of cardiovascular disease (CVD).² Although it has been identified as a potential biomarker of metabolic diseases and psoriasis has long been associated with metabolic dysfunction and obesity, its relationship with NHHR remains unclear.¹

The study used data from the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2014, initially including 30,468 participants. After excluding those with missing data on psoriasis (n = 10,941), missing data on non-HDL and HDL cholesterol (n = 1,823), and those under 20 years of age, a final sample of 15,951 adults were included.

Psoriasis status was determined from self-reported data, in which participants who answered “yes” after being told by a health care provider that they had psoriasis were considered to have this condition. NHHR was calculated by dividing non-HDL cholesterol by HDL cholesterol; it served as an independent variable.

The study also took into account various covariates, including age, gender, race, body mass index, triglycerides, cholesterol levels, diabetes, smoking, and socioeconomic factors. Logistic regression analysis was conducted to examine the relationship between NHHR and psoriasis, fitting different models to control for potential confounding variables. Additionally, an interaction test was used to determine whether the relationship between NHHR and psoriasis varied by subgroups such as gender, race, diabetes, and smoking.

The analysis demonstrated a positive correlation between psoriasis and NHHR. For each unit increase in NHHR, the risk of psoriasis increased by 7% (OR: 1.07; 95% CI, 1.01-1.14).

Additionally, individuals in the highest NHHR tertile had a 39% higher odds of developing psoriasis compared to those in the lowest tertile (OR, 1.39; 95% CI, 1.09-1. 78). This association between high NHHR and increased risk of psoriasis was consistently observed in various subgroups, confirming the robustness of the results.

However, the researchers noted some limitations. First, the diagnosis of psoriasis was based on self-reported data by health professionals or health practitioners, and this reliance on self-reporting could introduce reporting bias and lack of clinical validation. Second, the relatively small sample size of psoriasis patients in this study may have affected the reliability of the results. Third, given the cross-sectional nature of the study, it was impossible to establish a definitive causal relationship between psoriasis and NHHR. Finally, even though potential confounders were adjusted for, other unmeasured factors, such as daily medication use and lifestyle choices, could have influenced the study results.

Despite these limitations, the researchers believe the study suggests a link between high NHHR and a higher risk of developing psoriasis.

“The study results have strong clinical significance, particularly with regard to patient care and disease prevention,” the researchers wrote. “Study-based identification of the relationship between NHHR and psoriasis provides clinicians with a potential biomarker to identify at-risk patients in the clinic and implement targeted preventive measures.”

References

1. Jiang Y, Jia M. Association between non-HDL/HDL cholesterol ratio (NHHR) and psoriasis in adults: a cross-sectional study using data from 2009 to 2014. Clin Cosmet Investig Dermatol. 2024;17:2523-2531. doi:10.2147/CCID.S492053

2. Huang a cross-sectional analysis study. Scientific representative. 2024;14(1):24847. doi:10.1038/s41598-024-76002-y