Spatial distribution of residential environment, genetic susceptibility, and psoriasis: A prospective cohort study.

ABSTRACT

Background: Genetic and environmental factors contribute to psoriasis, but the impact of residential environments on this condition remains uncertain. We aimed to investigate the association of residential environments with psoriasis risk and explore its interaction with genes. Methods: We retrieved data on the spatial distribution of residential environments at 300 and 1000 m buffer zones from the UK Biobank, including the proportions of natural environments, domestic gardens, green spaces, and blue spaces within these zones. We then used Cox hazard models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between residential environments and psoriasis risk. Lastly, we constructed polygenic risk scores to determine genetic susceptibility and further analyse the interaction with residential environments. Results: Overall, 3755 incident cases of psoriasis were documented during a median follow-up of 12.45 years. Compared with the lowest exposure quantile (Q1), Q4 exposure to natural environments (1000 m buffer HR = 1.16, 95% CI = 1.05-1.29; 300 m buffer HR = 1.12, 95% CI = 1.02-1.24) and green spaces (1000 m buffer HR = 1.16, 95% CI = 1.04-1.28; 300m buffer HR = 1.10, 95% CI = 1.00-1.21) increased the risk of psoriasis, while Q4 exposure to domestic gardens (1000 m buffer HR = 0.85, 95% CI = 0.77-0.93; 300m buffer HR = 0.91, 95% CI = 0.83-1.00) and Q3 exposure to blue spaces (1000 m buffer HR = 0.89, 95% CI = 0.81-0.98) were negatively associated with psoriasis risk. Among participants with a high genetic risk, those exposed to high levels of natural environments (1000 m buffer HR = 1.49, 95% CI = 1.15-1.93; 300 m buffer HR = 1.39, 95% CI = 1.10-1.77) and green spaces (300 m buffer HR = 1.30, 95% CI = 1.04-1.64) had a higher risk of psoriasis, while those exposed to blue spaces (1000 m buffer HR = 0.78, 95% CI = 0.63-0.98) had a lower risk of psoriasis. We also observed joint effects of genetic risk and residential environments and an antagonistic additive interaction between blue spaces and genetic risk (P = 0.011). Conclusions: We observed that residing in natural environments and green areas increased the risk of psoriasis in our sample, while proximity to blue spaces and domestic gardens was associated to reduced risks. The association of residential environments with psoriasis risk was modified by genetic susceptibility.