Association of psoriasis and genetic predisposition for the risk of cardiometabolic diseases: a population-based cohort study.

BACKGROUND

Correlations have been reported between psoriasis and individual cardiometabolic diseases (CMDs), including coronary heart disease (CHD), stroke, hypertension, heart failure (HF) and type 2 diabetes mellitus (T2DM). However, the results are conflicting, and the role of genetic susceptibility in modifying these relationships remains unexplored.

OBJECTIVES

To investigate the association of psoriasis with the risk of CMDs and to assess the modified effect of genetic susceptibility on these associations.

METHODS

In total, 390 165 participants from the UK Biobank cohort were enrolled. Cox proportional hazards models were used to examine the association between psoriasis and the incidence of CMDs. The genetic risk score for these diseases was incorporated as tertiles to assess potential effect modification on these associations. The outcome was CMDs.

RESULTS

During a median 12.0-year follow-up, 23 811 incident CHD events, 6941 cases of HF, 82 963 cases of hypertension, 6902 strokes and 16 788 T2DM events were recorded. Participants with psoriasis had an increased risk of incident CHD [hazard ratio (HR) 1.11, 95% confidence interval (CI) 1.03-1.21], HF (HR 1.20, 95% CI 1.06-1.35), hypertension (HR 1.10, 95% CI 1.05-1.15) and T2DM (HR 1.22, 95% CI 1.11-1.34) compared with those without psoriasis. The adverse impact of psoriasis was pronounced among individuals with a high genetic predisposition. The elevated risk of CMDs associated with psoriasis may be partially explained by inflammation and dyslipidaemia.

CONCLUSIONS

Psoriasis was associated with the incidence of CMDs, particularly among individuals with higher genetic predisposition. Hence, our study emphasizes the significance of preventing and managing CMDs among patients with psoriasis, particularly those with high genetic risk.