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TOPLINE:

Low-grade systemic inflammation, indicated by elevated levels of systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (CRP), was associated with a higher risk of developing psoriasis in a large cohort study.

METHODOLOGY:

• Researchers analyzed data from 105,418 participants (median age, 58 years; 55% women) enrolled in the Copenhagen General Population Study between 2003 and 2015.
• Inflammatory markers (SII, NLR, and CRP) were measured from blood samples at baseline. Markers were categorized using percentile-based groupings: Below or above the 75th percentile and < 50th, 50th-90th, and > 90th percentiles.
• The median follow-up duration was 9.4 years. Psoriasis diagnoses were identified from the Danish National Patient Registry.

TAKEAWAY:

• Individuals with high SII (hazard ratio [HR], 1.40; 95% CI, 1.19-1.66 for levels ≥ 75th percentile vs < 75th) had a significantly higher risk for psoriasis. High levels of NLR (HR, 1.30; 95% CI, 1.10-1.54) and CRP (HR, 1.75; 1.48-2.06) also correlated with an increased risk for psoriasis.
• The risk for psoriasis rose with increasing levels of SII, NLR, and CRP from < 50th percentile to 50th-90th and > 90th percentiles (P for trend < .0001).
• Individuals with elevated levels of all three biomarkers had a 52% higher risk for psoriasis (95% CI, 1.17-1.97).
• Individuals with high levels of SII or CRP also had increased risk for psoriatic arthritis (adjusted HRs, 1.85 and 2.04, respectively). High levels of SII, NLR, and CRP were also associated with the development of rheumatoid arthritis (adjusted HRs, 1.81, 1.57, and 1.71, respectively).

IN PRACTICE:

“We found that low-grade systemic inflammation, measured as SII, NLR, and CRP, is an independent risk factor for psoriasis, especially moderate to severe disease,” authors of the study concluded. “These results support the hypothesis that low-grade systemic inflammation might be a contributing factor in the development of psoriasis. However, the potential clinical utility of SII, NLR, and CRP in prediction, prevention, or modulation of the disease requires further study,” they added.

SOURCE:

The study was led by Charlotte Näslund-Koch, MD, Department of Dermatology and Allergy, Copenhagen University Hospital, Copenhagen, Denmark. It was published online on April 18, 2025, in the British Journal of Dermatology.

LIMITATIONS:

Psoriasis diagnoses were limited to hospital-treated cases. Biomarker levels were assessed only at baseline. Additionally, with a median participant age of 58 years, these findings might have limited generalizability to early-onset disease.

DISCLOSURES:

The study received support from the Capital Region of Denmark’s Research Fund. Näslund-Koch disclosed serving as an investigator for Galderma, AbbVie, LEO Pharma, Novartis, and CSL Behring. Another author reported receiving research funding and having other ties with various sources. The other authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.