Dietary Inflammatory Index in Relation to Psoriasis Risk, Cardiovascular Risk Factors and Clinical Outcomes; A Result from Case-Control Study in Psoriasis Patients

Psoriasis is an inflammatory skin disease. Despite the understanding of the disease pathogenesis, the link between diet-induced inflammation and the risk of psoriasis remains underexplored. Therefore, we have examined the capability of literature-derived Energy-adjusted Dietary Inflammatory Index (E-DII) as a predictive tool for inflammation, incidence, and severity of psoriasis (as indexed by The Psoriasis Area Severity Index (PASI)). We have conducted a case-control study consisting of 149 adults (n = 75 cases and n = 74 controls). The E-DII score was calculated based on the dietary intake that was evaluated by a validated 168 item quantity food-frequency questionnaire. The E-DII tertile cut-offs were categorized based on the following cut points: tertiles 1 ≤ −1.99; tertiles 2 = −2.00 - 0.60; tertile 3 ≥ 0.61. Logistic regression models were applied to estimate the multivariable odds ratio (OR) that was adjusted for confounders. Patients with higher pro-inflammatory E-DII had a 3.60-times increased risk of psoriasis relative to patients in tertiles 1 (E-DIIT3 vs E-DIIT1: OR = 3.64; 95% CI 1.51, 8.79, P = 0.005). The severity of disease as indexed by PASI remained associated with E-DII (E-DIIT3 vs E-DIIT1: OR = 3.64; 95% CI 1.74, 7.57, P = 0.015). For each unit increase in E-DII, the odds of disease severity increased by 3-times. Patients consuming a more pro-inflammatory diet were at greater risk of psoriasis. These patients also demonstrate increased disease severity relative to individuals consuming a more anti-inflammatory diet. • A pro-inflammatory diet is associated with higher psoriasis incidence • Subjects with higher DII scores, had higher inflammatory markers levels.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author