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Low testosterone and limited sleep emerged as key, independent contributors to psoriasis risk, revealing modifiable targets for prevention in men.
A study published in June 2025 issue of Clinical, Cosmetic and Investigational Dermatology reported that low testosterone levels and sleep disturbances may contribute to heightened systemic inflammation in individuals with psoriasis.
Researchers examined the associations between low testosterone levels, short sleep duration, and the risk of psoriasis using data from the US National Health and Nutrition Examination Survey (NHANES) 2011–2014.
They assessed 4,060 male participants after excluding those with missing data on psoriasis, testosterone, sleep duration, or key covariates. Psoriasis status was self-reported. Testosterone levels were measured using isotope-dilution liquid chromatography-tandem mass spectrometry (ID-LC-MS/MS), and sleep duration was obtained via a self-reported questionnaire. Multivariable logistic regression was used to assess associations between testosterone, sleep duration, and psoriasis risk. Restricted cubic spline (RCS) analysis evaluated non-linear trends, and subgroup and sensitivity analyses tested the consistency of results.
The results showed that participants with testosterone levels under 300 ng/dL had a higher likelihood of psoriasis [OR = 2.97; 95% CI: 2.16–4.09; P < 0.001] in the fully adjusted model. Short sleep duration [< 7 hours] was also linked to increased psoriasis risk [OR = 1.76; 95% CI: 1.33–2.35; P < 0.001]. The RCS analysis indicated non-linear associations for both testosterone and sleep duration, with risk stabilizing at very low testosterone levels and sleep exceeding 8 hours. Sensitivity analysis, excluding those with testosterone > 1000 ng/dL, supported the stability of these findings.
Investigators concluded that low testosterone levels and short sleep duration were independently linked to higher psoriasis risk, pointing to hormonal and lifestyle factors as potential targets for prevention and management.
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