Association between psoriasis and Life's Essential 8 among adults in the United States

This study aimed to investigate the association between psoriasis and Life's Essential 8 (LE8), which has demonstrated an inverse relationship with various chronic diseases, though its link to psoriasis remains unexplored. In this cross-sectional study, we analyzed data from the National Health and Nutrition Examination Survey (NHANES) conducted during 2005 to 2006 and 2009 to 2014 that included participants who were 20 years or older. The LE8 score was calculated based on the American Heart Association's recommendations and categorized into three levels: low (0-49), moderate (50-79), and high (80-100). Psoriasis was identified using self-reported questionnaires. Weighted multivariable logistic regression and restricted cubic splines were applied to evaluate the relationship between LE8 scores and psoriasis. The study included 12,744 participants with an average age of 46.2 years (95% CI: 45.53-46.87 years); 6,289 (50.96%) were female, and 374 (2.9%) reported having psoriasis. The weighted mean LE8 score was 68.50 (95% CI: 67.94-69.07). After complete adjustment, a linear negative association was observed between psoriasis and the LE8 score (OR per 1 SD increase: 0.86, 95% CI: 0.75-0.99). Among the subscales, the health factors score showed a linear relationship with psoriasis, while a nonlinear relationship was found between psoriasis and the health behaviors score. Additionally, BMI, an LE8 component, demonstrated a significant association with psoriasis (OR per 1 SD increase: 0.84, 95% CI: 0.72-0.98) in multivariable logistic regression models. Subgroup and sensitivity analyses confirmed the robustness of these findings. We identified a linear negative relationship between psoriasis and LE8, demonstrating that improving LE8 management could serve as a potential strategy for preventing and managing psoriasis.