Association between sun-protective behaviours and psoriasis in US adults in the National Health and Nutrition Examination Survey, 2009–2014: a cross-sectional study

Objective To evaluate the association between sun-protective behaviours and psoriasis in a nationally representative sample of US adults.Design Analysis of cross-sectional data.Setting National Health and Nutrition Examination Survey (NHANES), 2009–2014.Participants A total of 9735 participants aged...

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Main Authors: Wen Li, Yibin Feng, Yawen Xuan, Fen Rong, Xufeng He, Wuqing Wang
Format: Article
Language:English
Published: BMJ Publishing Group 2025-02-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/2/e078050.full
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author Wen Li
Yibin Feng
Yawen Xuan
Fen Rong
Xufeng He
Wuqing Wang
author_facet Wen Li
Yibin Feng
Yawen Xuan
Fen Rong
Xufeng He
Wuqing Wang
author_sort Wen Li
collection DOAJ
description Objective To evaluate the association between sun-protective behaviours and psoriasis in a nationally representative sample of US adults.Design Analysis of cross-sectional data.Setting National Health and Nutrition Examination Survey (NHANES), 2009–2014.Participants A total of 9735 participants aged 20–59 years with available data on psoriasis, sun-protective behaviours and covariates were included in the analysis.Outcome measures Information on sun-protective behaviours (staying in the shade, wearing long sleeves and using sunscreen) and psoriasis was obtained from questionnaires in the NHANES database. Logistic regression models and subgroup analyses were employed to investigate the association between sun-protective behaviours and psoriasis.Results After adjusting for sociodemographic variables, body mass index (BMI), alcohol drinking status, smoking status, sun sensitivity and time spent outdoors in the multivariable logistic regression model, moderate wearing of long sleeves was negatively associated with psoriasis (OR, 0.55; 95% CI 0.33 to 0.90, p=0.02), while frequent wearing showed no significant relationship. There was no significant association between staying in the shade and psoriasis, regardless of frequency. Subgroup analyses stratified by age, gender, race/ethnicity and smoking status revealed no significant associations in most groups, but moderate wearing of long sleeves was found to be negatively associated with psoriasis among those aged 20–39 years (OR, 0.42; 95% CI 0.18 to 0.98, p=0.04), among non-Hispanic white individuals (OR, 0.52; 95% CI 0.28 to 0.97, p=0.04) and among non-smokers (OR, 0.49; 95% CI 0.25 to 0.95, p=0.04), as it was among women in terms of overall sun protection (OR, 0.58; 95% CI 0.35 to 0.97, p=0.04). However, among non-Hispanic white individuals (staying in the shade: OR, 1.69; 95% CI 1.00 to 2.84, p=0.049) and former/current smokers (overall: OR, 3.28; 95% CI 1.41 to 7.63, p=0.009), frequent sun protection was positively associated with psoriasis.Conclusions Moderate sun-protective behaviours among US adults were found to be negatively associated with psoriasis. However, among non-Hispanic white individuals and former/current smokers, frequent sun protection was positively associated with psoriasis. Future studies with rigorous study design could further explore and validate the potential reasons for these associations to better inform evidence-based behavioural recommendations that protect human health.
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spelling doaj-art-62877f913f6a4e04bc7978758022b21a2025-08-20T02:43:55ZengBMJ Publishing GroupBMJ Open2044-60552025-02-0115210.1136/bmjopen-2023-078050Association between sun-protective behaviours and psoriasis in US adults in the National Health and Nutrition Examination Survey, 2009–2014: a cross-sectional studyWen Li0Yibin Feng1Yawen Xuan2Fen Rong3Xufeng He4Wuqing Wang5Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, China6School of Chinese Medicine, The University of Hong Kong, Hong Kong, Hong KongDepartment of Dermatology, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaShanghai University of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Dermatology, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Dermatology, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaObjective To evaluate the association between sun-protective behaviours and psoriasis in a nationally representative sample of US adults.Design Analysis of cross-sectional data.Setting National Health and Nutrition Examination Survey (NHANES), 2009–2014.Participants A total of 9735 participants aged 20–59 years with available data on psoriasis, sun-protective behaviours and covariates were included in the analysis.Outcome measures Information on sun-protective behaviours (staying in the shade, wearing long sleeves and using sunscreen) and psoriasis was obtained from questionnaires in the NHANES database. Logistic regression models and subgroup analyses were employed to investigate the association between sun-protective behaviours and psoriasis.Results After adjusting for sociodemographic variables, body mass index (BMI), alcohol drinking status, smoking status, sun sensitivity and time spent outdoors in the multivariable logistic regression model, moderate wearing of long sleeves was negatively associated with psoriasis (OR, 0.55; 95% CI 0.33 to 0.90, p=0.02), while frequent wearing showed no significant relationship. There was no significant association between staying in the shade and psoriasis, regardless of frequency. Subgroup analyses stratified by age, gender, race/ethnicity and smoking status revealed no significant associations in most groups, but moderate wearing of long sleeves was found to be negatively associated with psoriasis among those aged 20–39 years (OR, 0.42; 95% CI 0.18 to 0.98, p=0.04), among non-Hispanic white individuals (OR, 0.52; 95% CI 0.28 to 0.97, p=0.04) and among non-smokers (OR, 0.49; 95% CI 0.25 to 0.95, p=0.04), as it was among women in terms of overall sun protection (OR, 0.58; 95% CI 0.35 to 0.97, p=0.04). However, among non-Hispanic white individuals (staying in the shade: OR, 1.69; 95% CI 1.00 to 2.84, p=0.049) and former/current smokers (overall: OR, 3.28; 95% CI 1.41 to 7.63, p=0.009), frequent sun protection was positively associated with psoriasis.Conclusions Moderate sun-protective behaviours among US adults were found to be negatively associated with psoriasis. However, among non-Hispanic white individuals and former/current smokers, frequent sun protection was positively associated with psoriasis. Future studies with rigorous study design could further explore and validate the potential reasons for these associations to better inform evidence-based behavioural recommendations that protect human health.https://bmjopen.bmj.com/content/15/2/e078050.full
spellingShingle Wen Li
Yibin Feng
Yawen Xuan
Fen Rong
Xufeng He
Wuqing Wang
Association between sun-protective behaviours and psoriasis in US adults in the National Health and Nutrition Examination Survey, 2009–2014: a cross-sectional study
BMJ Open
title Association between sun-protective behaviours and psoriasis in US adults in the National Health and Nutrition Examination Survey, 2009–2014: a cross-sectional study
title_full Association between sun-protective behaviours and psoriasis in US adults in the National Health and Nutrition Examination Survey, 2009–2014: a cross-sectional study
title_fullStr Association between sun-protective behaviours and psoriasis in US adults in the National Health and Nutrition Examination Survey, 2009–2014: a cross-sectional study
title_full_unstemmed Association between sun-protective behaviours and psoriasis in US adults in the National Health and Nutrition Examination Survey, 2009–2014: a cross-sectional study
title_short Association between sun-protective behaviours and psoriasis in US adults in the National Health and Nutrition Examination Survey, 2009–2014: a cross-sectional study
title_sort association between sun protective behaviours and psoriasis in us adults in the national health and nutrition examination survey 2009 2014 a cross sectional study
url https://bmjopen.bmj.com/content/15/2/e078050.full
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