The Inverse Association of Psoriasis and Life’s Crucial 9 in US Adults: An Analysis from NHANES

Jian-Chun Hao,1,* Dan-Ni Dou,2,* Shao-Wei Cheng,1 Ruo-Yu Gou3,* 1Department of Dermatology, Chuiyangliu Hospital Affiliated with Tsinghua University, Beijing, People’s Republic of China; 2School of Basic Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, People’s Republic of China; 3School of Public Health, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ruo-Yu Gou, School of Public Health, Ningxia Medical University, No. 1160 Shengli Street, Xingqing District, Yinchuan, 750003, People’s Republic of China, Tel +86 18202907106, Email [email protected]: Life’s Crucial 9 (LC9) is a new tool used to evaluate cardiovascular health. At present, no studies have reported the association between LC9 and psoriasis.Methods: This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2009 and 2014. The LC9 score was calculated based on the American Heart Association’s recommendations and the Patient Health Questionnaire-9 assessment. Psoriasis status was identified using self-reported questionnaires. Weighted multivariable logistic regression and restricted cubic splines were applied to assess the association between LC9 and psoriasis. Subgroup analyses were conducted for each covariate, and the interaction between LC9 and potential confounders was examined. Additionally, sensitivity analyses were performed to assess the robustness of the results.Results: A total of 11,762 participants aged 20 years and older were included in this study. After comprehensive adjustments, a negative linear association was observed between psoriasis and LC9: Each 10-point increment in LC9 corresponded to an odds ratio (OR) of 0.87 (95% CI: 0.78– 0.96) for psoriasis. Relative to participants in the lowest LC9 quartile (Q1), the ORs for psoriasis were 0.73 (95% CI: 0.55– 0.96) for Q3 and 0.55 (95% CI: 0.36– 0.85) for Q4. Among participants aged 45 to 64 years, those in the highest LC9 quartile (Q4) had an adjusted OR of 0.42 (95% CI: 0.23– 0.78). Heavy drinkers in Q4 exhibited an adjusted OR of 0.37 (95% CI: 0.15– 0.92). Sensitivity analyses confirmed these results.Conclusion: A linear negative relationship between psoriasis and LC9 was identified in this study. This observational result suggesting that enhancing LC9-related cardiovascular health factors may serve as an effective approach for psoriasis prevention and management.Keywords: national health and nutrition examination survey, NHANES, life’s crucial 9, LC9, psoriasis, cardiovascular health, predictive effect