The impact of lifestyle factors on cardiometabolic comorbidities and mortality of psoriatic diseases: A multistate model analysis.

Abstract

The role of lifestyle factors in the progression of psoriatic diseases (PDs) and cardiometabolic diseases (CMDs) remains underexplored. To assess the impact of lifestyle factors on transitions from a disease-free state to PDs, CMDs, their multimorbidity, and death. We analyzed 379,874 UK Biobank participants. Lifestyle factors included smoking status, body mass index (BMI), physical activity, and diet. An ideal lifestyle was defined as never smoking, BMI < 25 kg/m², and adequate physical activity. Multistate models were employed to evaluate their impacts on different transitions. Over 12.1 years, 2500 PD and 34,619 CMD incident events occurred. An ideal lifestyle showed protective effects on PD incidence among disease-free individuals, CMD incidence and all-cause mortality among PD patients, and all-cause mortality among patients with PD and CMD multimorbidity; the corresponding hazard ratios (95% confidence intervals) were 0.43 (0.36-0.51), 0.40 (0.31-0.53), 0.50 (0.31-0.81), and 0.64 (0.39-1.05), compared with participants who were ever-smokers, BMI ≥ 25 kg/m², and with inadequate physical activity. Ideal lifestyle added up to 5.3 years of life expectancy in PD participants. No verification in other ascertained population. Lifestyles are modifiable determinants and nonpharmaceutical strategies for preventing cardiometabolic comorbidities and mortality of PDs.