Body Composition, Cardiometabolic Risk Factors and Comorbidities in Psoriasis and the Effect of HLA-C*06:02 Status: The HUNT Study, Norway

Psoriasis has been associated with increased adiposity measures driving systemic inflammation, which may lead to metabolic dysfunction and comorbidities. In this population-based, cross-sectional study, we used data from 56 042 individuals in the fourth wave of the Trøndelag Health Study (HUNT4), to investigate the associations between psoriasis and body composition measures assessed using bioelectrical impedance analysis, cardiometabolic risk factors, and comorbidities. Further, we investigated the associations between HLA-C*06:02 status, a potential clinical biomarker for a distinct psoriasis endotype, and these outcomes. Psoriasis was associated with increased adiposity measures, including increased body and visceral fat, and lower levels of skeletal muscle and soft lean mass, as well as higher prevalence of cardiovascular, respiratory and endocrine disorders. HLA-C*06:02- positive individuals with psoriasis had lower levels of hsCRP, increased prevalence of atrial fibrillation and decreased prevalence of migraine. Our results point to altered body composition in psoriasis with increased levels of fat, and particularly metabolically active visceral fat, and provide support for a broad clinical approach to psoriatic patients in a general population. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The genetic investigations of the HUNT Study is a collaboration between researchers from the K.G. Jebsen Center for Genetic Epidemiology and University of Michigan Medical School, and the University of Michigang School of Public Health. The K.G. Jebsen Center for Genetic Epidemiology is financed by Stiftelsen Kristian Gerhard Jebsen; Faculty of Medicine and Health Sciences, NTNU, Norway. ML is supported by grants from the Liaison Committee for education, research and innovation in Central Norway. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Regional Committee for Medical and Health Research Ethics of Central Norway gave ethical approval for this work (REK Reference number: 27420). All participants signed informed consent. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Researchers associated with Norwegian research institutes can apply for the use of HUNT data and samples with approval by the Regional Committee for Medical and Health Research Ethics. Researchers from other countries may apply if collaborating with a Norwegian Principal Investigator. Information for data access can be found at . The HUNT variables are available for browsing on the HUNT databank at . Data linkages between HUNT and health registries require that the principal investigator has obtained project-specific approval for such linkage from the Regional Committee for Medical and Health Research Ethics, Norway and each registry owner.