The Association Between Non-High-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratio With Psoriasis: A Cross-Sectional Survey and Genetic Approach

This study utilised NHANES data from 2003 to 2006 and 2009 to 2014 to explore the association between the non-high-density lipoprotein to high-density lipoprotein cholesterol ratio (NHHR) and psoriasis. A total of 15 437 U.S. adults were analysed using multivariable logistic regression models that adjusted for cardiovascular disease, medication use, glucocorticoid therapy, and other covariates. Subgroup analyses by age, sex, and income were conducted. In addition, severity-stratified analyses were performed using data from the 2003 to 2006 and 2011 to 2014 cycles, where psoriasis severity information was available. Additional regression models comparing NHHR with traditional lipid markers (HDL-C, TC, non-HDL-C) were performed. Subsequently, Mendelian randomisation (MR) using GWAS summary statistics across European, East Asian, African, and Middle Eastern populations was conducted, with meta-analysis applied to improve precision. The results showed that NHHR was significantly associated with psoriasis (OR = 1.08, 95% CI: 1.00–1.17, p = 0.039), and those in the highest NHHR quartile had a 48% higher likelihood of developing psoriasis compared to those in the lowest quartile (OR = 1.48, 95% CI: 1.09–2.00).