Psoriasis and dyslipidemia: a population‐based study analyzing the National Health and Nutrition Examination Survey (NHANES)

Abstract

Psoriasis has been linked to an increased incidence of coronary artery disease, stroke, myocardial infarctions and cardiovascular deaths. Dyslipidemia, a well-established risk factor for cardiovascular disease, involves inflammatory pathways that are also implicated in psoriasis. An understanding of the relationship between psoriasis and dyslipidemia may have a substantial clinical impact. This study aimed to examine the association between psoriasis and multiple measurements of dyslipidemia, which include levels of triglycerides, apolipoprotein B, LDL-cholesterol, HDL-cholesterol, HDL/LDL ratio and total cholesterol. We conducted a population-based, cross-sectional study using the National Health and Nutrition Examination Survey (NHANES) 2003-2006 and 2009-2010. NHANES is a national research survey programme conducted biennially to evaluate the health and nutritional status of the U.S. population. The survey uses a multistage, stratified design. NHANES data were collected from questionnaires, physical examination and laboratory values. The sample population consisted of 13418 adults who provided responses to their psoriasis status. A total of 353 (2.63%) participants reported a health care provider-given diagnosis of psoriasis. The multivariate analysis showed that psoriasis was not significantly associated with certain measures of dyslipidemia from this population. Specifically, in psoriasis patients, the weighted odds ratio (OR) of total cholesterol >200mg/dL was 0.96 (95% CI 0.74-1.24); weighted OR of HDL-cholesterol <40mg/dL was 0.92 (95% CI 0.65-1.30); weighted OR of LDL-cholesterol >130mg/dL was 0.67 (95% CI 0.43-1.03); weighted OR of triglycerides >150mg/dL was 1.20 (95% CI 0.89-1.63); weighted OR of apolipoprotein B>130mg/dL was 1.29 (95% CI 0.69-2.41); weighted OR of HDL/LDL <0.4 was 1.20 (95% CI 0.8-1.79). Based on the NHANES data 2003-2006 and 2009-2010, psoriasis is not significantly associated with alterations in certain lipid levels. Larger sample sizes may be necessary to detect appreciable differences in the lipid levels between patients with and without psoriasis.