Higher non-HDL to HDL cholesterol ratio Linked to Increased Psoriasis Risk: Study
A new study published in the journal of Experimental Dermatology revealed higher non-HDL to HDL cholesterol ratio (NHHR) is positively associated with psoriasis prevalence, particularly in males, suggesting its potential as a clinical risk indicator.
This research used data from the U.S. National Health and Nutrition Examination Survey (NHANES) covering more than a decade of health records to investigate the association between the non-high-density lipoprotein to high-density lipoprotein cholesterol ratio (NHHR) and psoriasis. The analysis included 15,437 American adults and adjusted for a range of factors, including cardiovascular disease, medication use, and glucocorticoid therapy.
The findings showed that individuals with higher NHHR levels were significantly more likely to have psoriasis. Also, the individuals in the highest NHHR quartile had a 48% greater risk of developing the condition when compared to the individuals in the lowest quartile. On a continuous scale, every unit increase in NHHR was linked to an 8% higher odds of psoriasis (OR = 1.08, 95% CI: 1.00–1.17, p = 0.039).
The subgroup analyses were conducted across age, sex, and income groups. While the association was consistent, certain subpopulations showed stronger patterns which highlighted that lipid imbalance may interact differently with demographic and socioeconomic factors. In addition, when the severity of psoriasis was examined in specific survey cycles (2003–2006 and 2011–2014), higher NHHR was again associated with more severe forms of the disease.
The study also compared NHHR with traditional lipid markers, including HDL-C (good cholesterol), total cholesterol, and non-HDL-C. The cholesterol ratio outperformed individual markers in predicting psoriasis risk, suggesting that NHHR could be a more reliable tool for assessing lipid-related inflammation in patients at risk.
To extend these findings beyond observational data, this research employed Mendelian randomisation (MR) using genetic information from genome-wide association studies across diverse populations, which included European, East Asian, African, and Middle Eastern groups.
By applying meta-analysis, the MR component provided stronger precision and further supported the causal relationship between cholesterol imbalance and psoriasis. The base model demonstrated a modest but significant association, with the effect becoming stronger when stratified by NHHR quartiles. Additional columns compared traditional lipid measures, which showed weaker or inconsistent links.
Subgroup tables highlighted that younger adults and lower-income individuals had a more pronounced association. Severity-stratified tables highlighted the risk gradient, with higher NHHR linked to more extensive psoriasis involvement. Overall, these findings add to a growing body of evidence that psoriasis is not merely a skin condition but a systemic inflammatory disease tied to metabolic health.
Source:
Dai, H., Li, Z., Hu, J., Chen, W., Wang, Q., Liu, K., He, Y., & Li, L. (2025). The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio with psoriasis: A cross-sectional survey and genetic approach. Experimental Dermatology, 34(9), e70165. https://doi.org/10.1111/exd.70165
