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Serum Lipids and Risk of Incident Psoriasis: A Prospective Cohort Study from the UK Biobank Study and Mendelian Randomization Analysis

  • Author Footnotes
    6 These authors contributed equally to this work.
    Yi Xiao
    Footnotes
    6 These authors contributed equally to this work.
    Affiliations
    Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China

    Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China

    Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China

    National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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  • Author Footnotes
    6 These authors contributed equally to this work.
    Danrong Jing
    Footnotes
    6 These authors contributed equally to this work.
    Affiliations
    Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China

    Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China

    Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China

    National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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  • Zhenwei Tang
    Affiliations
    Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China

    Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China

    Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China

    National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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  • Cong Peng
    Affiliations
    Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China

    Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China

    Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China

    National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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  • Mingzhu Yin
    Affiliations
    Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China

    Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China

    Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China

    National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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  • Author Footnotes
    7 These authors contributed equally to this work.
    Hong Liu
    Footnotes
    7 These authors contributed equally to this work.
    Affiliations
    Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China

    Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China

    Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China

    National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
    Search for articles by this author
  • Author Footnotes
    7 These authors contributed equally to this work.
    Xiang Chen
    Footnotes
    7 These authors contributed equally to this work.
    Affiliations
    Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China

    Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China

    Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China

    National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
    Search for articles by this author
  • Author Footnotes
    7 These authors contributed equally to this work.
    Minxue Shen
    Correspondence
    Correspondence: Minxue Shen, Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, China.
    Footnotes
    7 These authors contributed equally to this work.
    Affiliations
    Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China

    Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China

    National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China

    Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
    Search for articles by this author
  • Author Footnotes
    6 These authors contributed equally to this work.
    7 These authors contributed equally to this work.
      The association between dyslipidemia and psoriasis has been studied widely. However, which individual indicators of serum lipids determine an increasing risk of incident psoriasis is still underappreciated in prospective cohorts. On the basis of UK Biobank, we investigate the causal relationship between four serum lipids and incident psoriasis by Cox proportional hazard model and Mendelian randomization analysis. After adjusting for covariates, high-density lipoprotein deficiency (<1.0 mmol/l for men, <1.3 mmol/l for women) and high triglyceride level (≥1.7 mmol/l) at baseline were associated with 16.6% and 10.6% increased risk of incident psoriasis, respectively. The effects were more pronounced in women, with 16.9 and 19.7% additional risk of psoriasis, respectively. The effects in the younger group (aged <60 years) and obese group in women were also more pronounced. No similar effect was observed in low-density lipoprotein and total cholesterol. Our subsequent Mendelian randomization analysis reinforced the main finding that high-density lipoprotein deficiency and high triglyceride cause incident psoriasis genetically. In conclusion, serum high-density lipoprotein/triglyceride levels predict psoriasis, particularly in women, indicating a distinct role of lipids engaging in the pathogenesis of psoriasis modified by sex. More metabolic-targeted, sex-specific management of psoriasis is suggested in the future.

      Abbreviations:

      BMI (body mass index), CI (confidence interval), HDL (high-density lipoprotein), HR (hazard ratio), LDL (low-density lipoprotein), MR (Mendelian randomization)
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