Associations of cardiovascular health and genetic susceptibility with incident psoriatic arthritis: findings from two cohort studies.

INTRODUCTION

Psoriatic arthritis (PsA), a chronic inflammatory disease associated with psoriasis, may be influenced by cardiovascular health (CVH). This study aims to investigate the associations between three CVH scores (Life's Simple 7 (LS7), Life's Essential 8 (LE8), and Life's Crucial 9 (LC9)) and a psychological health (PH) score with PsA risk and potential interactions with genetic susceptibility.

METHODS

Using data from the UK Biobank and NHANES cohorts, we conducted prospective and cross-sectional analyses employing Cox proportional hazards and multivariable logistic regression models, respectively. Additionally, a polygenic risk score (PRS) was derived in the UK Biobank to quantify genetic susceptibility to PsA and examine its interactions with CVH and PH metrics.

RESULTS

Higher scores in LE8, LC9, and PH showed consistent inverse associations with PsA, with the most pronounced association observed for LC9. Higher LC9 scores showed a strong inverse association with PsA (highest vs lowest group: OR = 0.25 (95% CI 0.05, 0.86), HR = 0.20 (95% CI 0.06, 0.65)). Each 10-point LC9 increase corresponded to lower PsA risk (OR = 0.76 (95% CI 0.58, 0.98), HR = 0.68 (95% CI 0.54, 0.86)). Genetic risk (assessed as the inverse of the PRS) showed significant antagonistic interactions with LE8, LC9, and PH scores.

CONCLUSION

Inverse associations were observed between LE8, LC9, and PH scores and PsA risk, along with notable interactions with genetic predisposition. Key Points • Higher LE8, LC9, and PH scores showed inverse associations with PsA. • LC9 showed the strongest inverse association with PsA in both cohorts. • Genetic susceptibility showed antagonistic interactions with LE8, LC9 and PH scores.