Location Matters: Belly Fat Compared to Overall Body Fat More Strongly Linked to Psoriasis Risk

Researchers have found that central body fat, especially around the abdomen, is more strongly linked to psoriasis risk than total body fat, particularly in women. This link between central fat and psoriasis remained consistent regardless of genetic predisposition, indicating that abdominal fat is an independent risk factor. The study opens in new tab/window in the Journal of Investigative Dermatology opens in new tab/window, published by Elsevier, provides insights that could help improve early risk prediction and guide personalized prevention strategies.

Psoriasis is a chronic inflammatory skin condition that can have a significant impact on quality of life. Many individuals with psoriasis also have elevated levels of body fat. While it is well established that increasing levels of body fat raise the risk of developing psoriasis, the impact of specific fat distribution and genetics remains unclear.

Researchers of the current study analyzed data from over 330,000 participants with White British ancestry in the UK Biobank, including more than 9,000 people with psoriasis. They examined 25 different measures of body fat using both traditional methods and advanced imaging techniques, assessing how each was associated with psoriasis.

Lead investigator Ravi Ramessur, MD, St John’s Institute of Dermatology, King’s College London, explains, "Our research shows that where fat is stored in the body matters when it comes to psoriasis risk. Central fat — especially around the waist — seems to play a key role. This has important implications for how we identify individuals who may be more likely to develop psoriasis or experience more severe disease, and how we approach prevention and treatment strategies."

Catherine H. Smith, MD, also at St John’s Institute of Dermatology, King’s College London, and senior author adds, “As rates of obesity continue to rise globally, understanding how different patterns of body fat influence chronic inflammatory conditions such as psoriasis is important. Our findings suggest that central body fat contributes to psoriasis risk irrespective of genetic predisposition and reinforces the importance of measuring waist circumference and pro-active healthy weight strategies in psoriasis care.”

Because this study only included individuals of White British ancestry from the UK Biobank, the generalizability of these findings to more diverse populations may be limited. Future studies incorporating datasets with dermatologist-confirmed diagnoses and broader ethnic representation will be important to further validate these associations and refine risk stratification approaches.

Dr. Ramessur notes, "We were surprised by how consistently strong the association was across different central fat measures and how much stronger the effect was in women. The observed links between central body fat and psoriasis suggest that there may be underlying biological mechanisms contributing to the disease that are not yet fully understood and which warrant further investigation."

In an accompanying editorial opens in new tab/window Joel M. Gelfand, MD, MSCE, FAAD, Department of Dermatology and Center for Clinical Sciences in Dermatology, University of Pennsylvania Perelman School of Medicine, points to the potential of incretin therapy for psoriatic disease. Incretins are gut-derived hormones, principally glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP), that regulate glucose, digestion, and appetite, and are approved for treatment of diabetes, obesity, and obesity-associated obstructive sleep apnea.

Dr. Gelfand comments, “The strong relationship between psoriasis and obesity and the emerging promise of glucagon-like peptide-1 receptor agonists (GLP1RA) for reducing psoriasis morbidity is a call to action for large scale clinical trials of GLP1RA monotherapy for treatment of psoriasis. Our current paradigm of just focusing on the skin and joint manifestations when treating psoriasis is outdated in the context of our evolving understanding of the tight relationship of psoriasis, obesity, and cardiometabolic disease.“

Notes for editors

The article is “Investigating the Genetic Basis of the Influence of Adiposity on Psoriasis: A Cross-Sectional Study in a Large United Kingdom Population–Based Biobank,” by Ravi Ramessur, Jake Saklatvala, Mari Løset, Laurent F. Thomas, Ashley Budu-Aggrey, Satveer K. Mahil, Jonathan N. Barker, Nick Dand, Michael A. Simpson, and Catherine H. Smith (https://doi.org/10.1016/j.jid.2025.03.024 opens in new tab/window). The article is openly available for 60 days at https://www.jidonline.org/article/S0022-202X(25)00391-4/fulltext opens in new tab/window.

The editorial is “The Visceral Relationship of Psoriasis and Obesity,” by Joel. M. Gelfand (https://doi.org/10.1016/j.jid.2025.04.013 opens in new tab/window). The editorial is openly available for 60 days at https://www.jidonline.org/article/S0022-202X(25)00456-2/fulltext opens in new tab/window.

They appear online in the Journal of Investigative Dermatology, published by Elsevier.

The full text of the articles is also available to credentialed journalists upon request; contact Eileen Leahy at +1 732 406 1313 or [email protected] opens in new tab/window. Journalists wishing to interview the authors should contact Bethan Warman, Senior Communications Officer, King’s College London, at [email protected] opens in new tab/window. Joel M. Gelfand, MD, MSCE, FAAD, may be reached for comment at [email protected] opens in new tab/window.

This project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No 821511 (BIOMAP). The JU receives support from the European Union’s Horizon 2020 research and innovation program and EFPIA. This publication reflects only the authors’ views, and the JU is not responsible for any use that may be made of the information it contains.

This research was supported by the King’s Health Partners Centre for Translational Medicine. The views expressed are those of the authors and not necessarily those of King’s Health Partners. This study was also supported by the Psoriasis Association, UK.

About the Journal of Investigative Dermatology

The Journal of Investigative Dermatology opens in new tab/window (JID) is the official journal of the Society of Investigative Dermatology and the European Society for Dermatological Research. JID publishes high impact reports describing original research related to all aspects of cutaneous biology and skin diseases. Descriptions of important findings that result from basic, translational, or clinical research are published. Clinical research can include, but is not limited to, interventional trials, genetics studies, epidemiology, and health services research. www.jidonline.org opens in new tab/window

About Elsevier

A global leader in advanced information and decision support, Elsevier helps to advance science and healthcare, to advance human progress. We do this by facilitating insights and critical decision-making with innovative solutions based on trusted, evidence-based content and advanced AI-enabled digital technologies.

We have supported the work of our research and healthcare communities for more than 140 years. Our 9,700 employees around the world, including 2,300 technologists, are dedicated to supporting researchers, librarians, academic leaders, funders, governments, R&D-intensive companies, doctors, nurses, future healthcare professionals and educators in their critical work. Our 3,000 scientific journals and iconic reference books include the foremost titles in their fields, including Cell Press, The Lancet and Gray’s Anatomy. Together with the Elsevier Foundation opens in new tab/window, we work in partnership with the communities we serve to advance inclusion in science, research and healthcare in developing countries and around the world.

Elsevier is part of RELX opens in new tab/window, a global provider of information-based analytics and decision tools for professional and business customers. For more information on our work, digital solutions and content, visit www.elsevier.com.