No CrossRef data available.
Article contents
Increased antioxidant levels favour psoriasis risk reduction in specific populations: a cross-sectional study based on National Health and Nutrition Examination Survey (NHANES)
Published online by Cambridge University Press: 02 January 2026
Abstract
Oxidative stress is an important pathomechanism in psoriasis, and the oxidative balance score (OBS) serves as a standardised metric for assessing systemic oxidative status, but its association with psoriasis is unclear. This study included 18 023 adults from the National Health and Nutrition Examination Survey to investigate the relationship between OBS and psoriasis. After using a complex sampling weighting method, we performed multi-model logistic regression and stratified analysis with OBS as the exposure and psoriasis as the outcome for the primary analysis. Restricted cubic spline (RCS) plots were used to evaluate potential non-linear associations between OBS and psoriasis. In addition, we performed replication analyses using two 24-h dietary records data as a sensitivity test to ensure robustness of the results. Multi-model logistic regression analyses revealed no statistically meaningful link between OBS and psoriasis prevalence when accounting for all confounders (P > 0·05), but in stratified analyses, OBS demonstrated a significant association with reduced risk of psoriasis in individuals aged 60–80 years (OR = 0·27–0·35, P < 0·05). As part of the overall OBS, moderate dietary OBS demonstrated an association with reduced psoriasis risk in 60- to 80-year-olds (OR = 0·39–0·43, P < 0·05). Lifestyle OBS (LOBS) indicates a significant negative correlation with psoriasis risk among the ‘Other Hispanic’ group. (Q3 OR = 0·23, P < 0·05). The RCS showed a non-linear relationship between LOBS and psoriasis (non-linear P = 0·013). This study provides the first systematic confirmation of an association between OBS and a reduced risk of psoriasis in elderly populations and specific ethnic groups. These findings offer new insights and directions for the prevention and treatment of psoriasis.
Keywords
Information
- Type
- Research Article
- Information
- Copyright
- © The Author(s), 2026. Published by Cambridge University Press on behalf of The Nutrition Society
Footnotes
†
These authors are co-first authors of the article and contributed equally to this work.
References
Szepietowski, JC & Reich, A (2016) Pruritus in psoriasis: an update. Eur J Pain 20, 41–46.Google Scholar
Griffiths, CEM, Armstrong, AW, Gudjonsson, JE, et al. (2021) Psoriasis. Lancet 397, 1301–1315.Google Scholar
Piaserico, S, Orlando, G & Messina, F (2022) Psoriasis and cardiometabolic diseases: shared genetic and molecular pathways. Int J Mol Sci 23, 9063.Google Scholar
Jin, JQ, Elhage, KG, Spencer, RK, et al. (2023) Mendelian randomization studies in psoriasis and psoriatic arthritis: a systematic review. J Invest Dermatol 143, 762–776.e3.Google Scholar
Wu, JJ, Kavanaugh, A, Lebwohl, MG, et al. (2022) Psoriasis and metabolic syndrome: implications for the management and treatment of psoriasis. J Eur Acad Dermatol Venereol 36, 797–806.Google Scholar
Parisi, R, Iskandar, IYK, Kontopantelis, E, et al. (2020) National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study. BMJ 369, m1590.Google Scholar
Lee, HJ & Kim, M (2023) Challenges and future trends in the treatment of psoriasis. Int J Mol Sci 24.Google Scholar
Reid, C & Griffiths, CEM (2020) Psoriasis and treatment: past, present and future aspects. Acta Derm Venereol 100, adv00032.Google Scholar
Lwin, SM, Snowden, JA & Griffiths, CEM (2021) The promise and challenges of cell therapy for psoriasis. Br J Dermatol 185, 887–898.Google Scholar
Pizzino, G, Irrera, N, Cucinotta, M, et al. (2017) Oxidative stress: harms and benefits for human health. Oxid Med Cell Longev 2017, 8416763.Google Scholar
Dobrică, EC, Cozma, MA, Găman, MA, et al. (2022) The involvement of oxidative stress in psoriasis: a systematic review. Antioxidants (Basel) 11, 282.Google Scholar
Hussain, T, Tan, B, Yin, Y, et al. (2016) Oxidative stress and inflammation: what polyphenols can do for us? Oxid Med Cell Longev 2016, 7432797.Google Scholar
Pleńkowska, J, Gabig-Cimińska, M & Mozolewski, P (2020) Oxidative stress as an important contributor to the pathogenesis of psoriasis. Int J Mol Sci 21, 6206.Google Scholar
Baek, JO, Byamba, D, Wu, WH, et al. (2012) Assessment of an imiquimod-induced psoriatic mouse model in relation to oxidative stress. Arch Dermatol Res 304, 699–706.Google Scholar
Wang, WM & Jin, HZ (2020) Role of neutrophils in psoriasis. J Immunol Res 2020, 3709749.Google Scholar
Chiang, CC, Cheng, WJ, Korinek, M, et al. (2019) Neutrophils in psoriasis. Front Immunol 10, 2376.Google Scholar
Bakić, M, Klisić, A, Kocić, G, et al. (2024) Oxidative stress and metabolic biomarkers in patients with psoriasis. J Med Biochem 43, 97–105.Google Scholar
Lin, P, Shi, HY, Lu, YY, et al. (2023)
Centella asiatica alleviates psoriasis through JAK/STAT3-mediated inflammation: an in vitro and in vivo study. J Ethnopharmacol 317, 116746.Google Scholar
Zeng, B, Yan, Y, Zhang, Y, et al. (2024)
Dendrobium officinale Polysaccharide (DOP) inhibits cell hyperproliferation, inflammation and oxidative stress to improve keratinocyte psoriasis-like state. Adv Med Sci 69, 167–175.Google Scholar
Quintanilha, BJ, Reis, BZ, Duarte, GBS, et al. (2017) Nutrimiromics: role of microRNAs and nutrition in modulating inflammation and chronic diseases. Nutrients 9, 1168.Google Scholar
Zheng, Q, Sun, XY, Miao, X, et al. (2018) Association between physical activity and risk of prevalent psoriasis: a MOOSE-compliant meta-analysis. Medicine (Baltimore) 97, e11394.Google Scholar
Lei, X, Xu, Z & Chen, W (2023) Association of oxidative balance score with sleep quality: NHANES 2007–2014. J Affect Disord 339, 435–442.Google Scholar
Zhang, W, Peng, SF, Chen, L, et al. (2022) Association between the oxidative balance score and telomere length from the national health and nutrition examination survey 1999–2002. Oxid Med Cell Longev 2022, 1345071.Google Scholar
Cheng, S, Han, Y, Jiang, L, et al. (2023) Associations of oxidative balance score and visceral adiposity index with risk of ischaemic heart disease: a cross-sectional study of NHANES, 2005–2018. BMJ Open 13, e072334.Google Scholar
Xu, Z, Liu, D, Zhai, Y, et al. (2024) Association between the oxidative balance score and all-cause and cardiovascular mortality in patients with diabetes and prediabetes. Redox Biol 76, 103327.Google Scholar
Li, H, Zhang, Z, Liu, S, et al. (2024) Relationship between oxidative balance score and prostate cancer: a cross-sectional study of NHANES, 1999–2010. BMJ Open 14, e084700.Google Scholar
Mahemuti, N, Jing, X, Zhang, N, et al. (2023) Association between systemic immunity-inflammation index and hyperlipidemia: a population-based study from the NHANES (2015–2020). Nutrients 15, 1177.Google Scholar
National Cholesterol Education Program Expert Panel on Detection E, Treatment of High Blood Cholesterol in A (2002) Third Report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation 106, 3143–3421.Google Scholar
Qi, Q, Sun, K, Rong, Y, et al. (2022) Body composition of the upper limb associated with hypertension, hypercholesterolemia, and diabetes. Front Endocrinol (Lausanne) 13, 985031.Google Scholar
Blackburn, EH, Epel, ES & Lin, J (2015) Human telomere biology: a contributory and interactive factor in aging, disease risks, and protection. Science 350, 1193–1198.Google Scholar
Luo, J, Mills, K, le Cessie, S, et al. (2020) Ageing, age-related diseases and oxidative stress: what to do next? Ageing Res Rev 57, 100982.Google Scholar
Kudryavtseva, AV, Krasnov, GS, Dmitriev, AA, et al. (2016) Mitochondrial dysfunction and oxidative stress in aging and cancer. Oncotarget 7, 44879–44905.Google Scholar
Dai, DF, Chiao, YA, Martin, GM, et al. (2017) Mitochondrial-targeted catalase: extended longevity and the roles in various disease models. Prog Mol Biol Transl Sci 146, 203–241.Google Scholar
Huang, B, Zhang, N, Qiu, X, et al. (2024) Mitochondria-targeted SkQ1 nanoparticles for dry eye disease: inhibiting NLRP3 inflammasome activation by preventing mitochondrial DNA oxidation. J Control Release 365, 1–15.Google Scholar
Xu, W, Mu, D, Wang, Y, et al. (2024) Association between oxidative balance score and sarcopenia in US adults: NHANES 2011–2018. Front Nutr 11, 1342113.Google Scholar
Liu, S, Pi, J & Zhang, Q (2022) Signal amplification in the KEAP1-NRF2-ARE antioxidant response pathway. Redox Biol 54, 102389.Google Scholar
Barros, G, Duran, P, Vera, I, et al. (2022) Exploring the links between obesity and psoriasis: a comprehensive review. Int J Mol Sci 23, 7499.Google Scholar
Wang, J, Zhang, B, Peng, L, et al. (2023) The causal association between alcohol, smoking, coffee consumption, and the risk of arthritis: a meta-analysis of Mendelian randomization studies. Nutrients 15, 5009.Google Scholar
Wang, Y, Yang, Q & Zheng, L (2023) Association of oxidative stress, programmed cell death, GSTM1 gene polymorphisms, smoking and the risk of lung carcinogenesis: a two-step Mendelian randomization study. Front Physiol 14, 1145129.Google Scholar
Ramessur, R, Saklatvala, J, Budu-Aggrey, A, et al. (2024) Exploring the link between genetic predictors of cardiovascular disease and psoriasis. JAMA Cardiol 9, 1009–1017.Google Scholar
Shi, Z, Wu, X, Yu, S, et al. (2020) Short-term exposure to a western diet induces psoriasiform dermatitis by promoting accumulation of IL-17A-producing γδ T cells. J Invest Dermatol 140, 1815–1823.Google Scholar
Anderson, J, Do, LAH, Toh, ZQ, et al. (2020) Vitamin D induces differential effects on inflammatory responses during bacterial and/or viral stimulation of human peripheral blood mononuclear cells. Front Immunol 11, 602.Google Scholar
Umar, M, Sastry, KS, Al Ali, F, et al. (2018) Vitamin D and the pathophysiology of inflammatory skin diseases. Skin Pharmacol Physiol 31, 74–86.Google Scholar
Xu, J, Wang, W, Zhong, XX, et al. (2016) EXPRESS: methylcobalamin ameliorates neuropathic pain induced by vincristine in rats: effect on loss of peripheral nerve fibers and imbalance of cytokines in the spinal dorsal horn. Mol Pain 12, 1744806916657089.Google Scholar
Wu, R, Tian, H, Zhao, T, et al. (2024) A Mendelian randomization analysis of inflammatory skin disease risk due to mineral deficiencies. Front Nutr 11, 1404117.Google Scholar
Ma, J, Liu, Z, Gao, X, et al. (2023) Gut microbiota remodeling improves natural aging-related disorders through Akkermansia muciniphila and its derived acetic acid. Pharmacol Res 189, 106687.Google Scholar
Peng et al. supplementary material
Peng et al. supplementary material
File
97.1 KB