{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:02:57Z","timestamp":1782846177922,"version":"3.54.5"},"reference-count":49,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Med Inform"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Psoriasis is a chronic inflammatory skin disorder that has been increasingly linked to metabolic imbalances, particularly obesity. Conventional anthropometric indicators such as BMI and waist circumference (WC) may not sufficiently capture body fat distribution or reflect metabolic risk. The body roundness index (BRI), which integrates both height and waist measurements, has emerged as a potentially superior metric, though its relevance to psoriasis risk remains underexplored.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to investigate the use of BRI as a digital biomarker for assessing psoriasis risk and to compare its predictive strength against BMI and WC across various demographic and metabolic subgroups using data from a nationally representative sample.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A cross-sectional analysis was conducted using data from 13,798 adults aged 20 to 59 years who participated in the National Health and Nutrition Examination Survey between 2003 and 2006 as well as between 2009 and 2014. Psoriasis status was self-reported. Anthropometric measures (BRI, BMI, and WC) were calculated from standardized physical assessments. Weighted multivariable logistic regression models and restricted cubic spline analyses were used to examine associations while adjusting for demographic, metabolic, and lifestyle variables. A nomogram was constructed to quantify the relative predictive contributions of each metric.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n BRI exhibited a strong linear association with psoriasis risk (odds ratio [OR] 1.11 per unit increase, 95% CI 1.05\u20101.17;\n P<\/jats:italic>\n <.001), outperforming BMI (OR 1.03) and WC (OR 1.01). Tertile analysis revealed a 1.73-fold increased risk of psoriasis in the highest BRI group (\n P<\/jats:italic>\n =.003). Subgroup analyses confirmed consistent associations across age, sex, race or ethnicity, and metabolic status (\n P<\/jats:italic>\n for interaction >.05). The nomogram highlighted BRI as the most influential predictor, indicated by its broad scoring range.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n BRI shows stronger and more consistent associations with psoriasis risk than BMI or WC, supporting its potential role as a digital biomarker for early risk stratification. Incorporating BRI into clinical decision-making tools may enhance personalized approaches to psoriasis prevention and management.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/75727","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T15:30:09Z","timestamp":1761233409000},"page":"e75727-e75727","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the Body Roundness Index as a Novel Digital Biomarker for Psoriasis Risk Prediction: Cross-Sectional Study"],"prefix":"10.2196","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9259-8083","authenticated-orcid":false,"given":"Pengfei","family":"Wen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4291-7776","authenticated-orcid":false,"given":"Xiaoyan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6088-5915","authenticated-orcid":false,"given":"Xiaoxue","family":"Zhuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5621-1249","authenticated-orcid":false,"given":"Siliang","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"issue":"3","key":"R1","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jaad.2016.07.064","article-title":"Psoriasis and comorbid diseases: epidemiology","volume":"76","author":"Takeshita","journal-title":"J Am Acad Dermatol"},{"issue":"12","key":"R2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22126561","article-title":"Aberrations in lipid expression and metabolism in psoriasis","volume":"22","author":"Nowowiejska","journal-title":"Int J Mol Sci"},{"issue":"Suppl 2","key":"R3","doi-asserted-by":"publisher","first-page":"ii18","DOI":"10.1136\/ard.2004.033217","article-title":"Psoriasis: epidemiology, clinical features, and quality of life","volume":"64 Suppl 2","author":"Langley","journal-title":"Ann Rheum Dis"},{"issue":"13","key":"R4","doi-asserted-by":"publisher","first-page":"1613","DOI":"10.2169\/internalmedicine.56.8209","article-title":"Cardiovascular and metabolic diseases comorbid with psoriasis: beyond the skin","volume":"56","author":"Furue","journal-title":"Intern Med"},{"issue":"19","key":"R5","doi-asserted-by":"publisher","first-page":"1945","DOI":"10.1001\/jama.2020.4006","article-title":"Pathophysiology, clinical presentation, and treatment of psoriasis: a review","volume":"323","author":"Armstrong","journal-title":"JAMA"},{"issue":"18","key":"R6","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20184347","article-title":"Risk factors for the development of psoriasis","volume":"20","author":"Kamiya","journal-title":"Int J Mol Sci"},{"issue":"3","key":"R7","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-3387","article-title":"Psoriasis and co-morbidity","volume":"100","author":"Amin","journal-title":"Acta Derm Venereol"},{"issue":"16","key":"R8","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23169063","article-title":"Psoriasis and cardiometabolic diseases: shared genetic and molecular pathways","volume":"23","author":"Piaserico","journal-title":"Int J Mol Sci"},{"issue":"20","key":"R9","doi-asserted-by":"publisher","DOI":"10.3390\/ijms232012137","article-title":"Impact of ROS-dependent lipid metabolism on psoriasis pathophysiology","volume":"23","author":"Wro\u0144ski","journal-title":"Int J Mol Sci"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.711060","article-title":"Metabolic syndrome and psoriasis: mechanisms and future directions","volume":"12","author":"Hao","journal-title":"Front Immunol"},{"issue":"1","key":"R11","doi-asserted-by":"publisher","DOI":"10.1080\/09546634.2024.2375580","article-title":"Molecular mechanisms and drug therapy of metabolism disorders in psoriasis","volume":"35","author":"Liang","journal-title":"J Dermatolog Treat"},{"issue":"6","key":"R12","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1159\/000455840","article-title":"Psoriasis and obesity","volume":"232","author":"Jensen","journal-title":"Dermatology (Basel)"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.01807","article-title":"Psoriasis: obesity and fatty acids","volume":"10","author":"Kunz","journal-title":"Front Immunol"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","first-page":"0","DOI":"10.5604\/01.3001.0010.3854","article-title":"Compounds of psoriasis with obesity and overweight","volume":"71","author":"Owczarczyk-Saczonek","journal-title":"Postepy Hig Med Dosw"},{"issue":"14","key":"R15","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23147499","article-title":"Exploring the links between obesity and psoriasis: a comprehensive review","volume":"23","author":"Barros","journal-title":"Int J Mol Sci"},{"issue":"3","key":"R16","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1590\/s0365-05962010000300009","article-title":"Psoriasis and obesity: literature review and recommendations for management","volume":"85","author":"Duarte","journal-title":"An Bras Dermatol"},{"issue":"11","key":"R17","doi-asserted-by":"publisher","first-page":"1876","DOI":"10.1111\/jdv.13701","article-title":"The triad psoriasis-obesity-adipokine profile","volume":"30","author":"Coimbra","journal-title":"Acad Dermatol Venereol"},{"issue":"18","key":"R18","doi-asserted-by":"publisher","DOI":"10.3390\/nu15183876","article-title":"Metabolic disorders and psoriasis: exploring the role of nutritional interventions","volume":"15","author":"Cintoni","journal-title":"Nutrients"},{"issue":"7 Suppl","key":"R19","first-page":"s176","volume":"22","author":"Apovian","journal-title":"Am J Manag Care"},{"issue":"5","key":"R20","doi-asserted-by":"publisher","first-page":"1308","DOI":"10.1097\/CCM.0b013e3181d8cd8b","article-title":"Predictive value of abdominal obesity vs. body mass index for determining risk of intensive care unit mortality","volume":"38","author":"Paolini","journal-title":"Crit Care Med"},{"issue":"1","key":"R21","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1017\/s0007114598001809","article-title":"Self-reported waist circumference compared with the \u201cWaist Watcher\u201d tape-measure to identify individuals at increased health risk through intra-abdominal fat accumulation","volume":"80","author":"Han","journal-title":"Br J Nutr"},{"issue":"6","key":"R22","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.15051","article-title":"Body roundness index and all-cause mortality among US adults","volume":"7","author":"Zhang","journal-title":"JAMA Netw Open"},{"issue":"7","key":"R23","doi-asserted-by":"publisher","first-page":"60","DOI":"10.3390\/diabetology6070060","article-title":"Body roundness index (BRI) predicts metabolic syndrome in postmenopausal women with obesity better than insulin resistance","volume":"6","author":"de Luis","journal-title":"Diabetology"},{"key":"R24","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2025.1524352","article-title":"Association of body roundness index with cardiovascular disease in patients with cardiometabolic syndrome: a cross-sectional study based on NHANES 2009-2018","volume":"16","author":"He","journal-title":"Front Endocrinol"},{"issue":"1","key":"R25","doi-asserted-by":"publisher","DOI":"10.1186\/s12944-024-02365-w","article-title":"Association between body roundness index and psoriasis among US adults: a nationwide population-based study","volume":"23","author":"Bai","journal-title":"Lipids Health Dis"},{"key":"R26","unstructured":"National health and nutrition examination survey. Centers for Disease Control and Prevention. URL: https:\/\/www.cdc.gov\/nchs\/nhanes\/index.html [Accessed 09-12-2025]"},{"issue":"10","key":"R27","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.2340\/00015555-2749","article-title":"Agreement between self-reported inflammatory skin disorders and dermatologists\u2019 diagnosis: a cross-sectional diagnostic study","volume":"97","author":"Phan","journal-title":"Acta Derm Venereol"},{"issue":"7","key":"R28","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1001\/jamadermatol.2022.1609","article-title":"Association between psoriasis and nonalcoholic fatty liver disease among outpatient US adults","volume":"158","author":"Ruan","journal-title":"JAMA Dermatol"},{"issue":"11","key":"R29","doi-asserted-by":"publisher","first-page":"2264","DOI":"10.1002\/oby.20408","article-title":"Relationships between body roundness with body fat and visceral adipose tissue emerging from a new geometrical model","volume":"21","author":"Thomas","journal-title":"Obesity (Silver Spring)"},{"issue":"2","key":"R30","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glad175","article-title":"Association of dietary live microbes and nondietary prebiotic\/probiotic intake with cognitive function in older adults: evidence from NHANES","volume":"79","author":"Tang","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"1","key":"R31","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-023-16225-2","article-title":"Association between pyrethroid exposure and osteoarthritis: a national population-based cross-sectional study in the US","volume":"23","author":"Liang","journal-title":"BMC Public Health"},{"issue":"3","key":"R32","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1002\/oby.23653","article-title":"Obesity and overweight are linked to increased sodium-glucose cotransporter 1 and glucose transporter 5 levels in duodenum","volume":"31","author":"Fiorentino","journal-title":"Obesity (Silver Spring)"},{"key":"R33","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2023.111022","article-title":"Trends and risk factors of diabetes and prediabetes in US adolescents, 1999-2020","volume":"207","author":"Ouyang","journal-title":"Diabetes Res Clin Pract"},{"issue":"Suppl 1","key":"R34","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1007\/s00508-022-02122-y","article-title":"Diabetes mellitus: Definition, classification, diagnosis, screening and prevention (update 2023)","volume":"135","author":"Harreiter","journal-title":"Wien Klin Wochenschr"},{"issue":"1","key":"R35","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1212\/01.wnl.0000287072.93277.c9","article-title":"Association of restless legs syndrome and cardiovascular disease in the Sleep Heart Health Study","volume":"70","author":"Winkelman","journal-title":"Neurology (ECronicon)"},{"issue":"7","key":"R36","doi-asserted-by":"publisher","first-page":"e434","DOI":"10.1016\/S2589-7500(21)00079-0","article-title":"Association between change in cardiovascular risk scores and future cardiovascular disease: analyses of data from the Whitehall II longitudinal, prospective cohort study","volume":"3","author":"Lindbohm","journal-title":"Lancet Digit Health"},{"issue":"16","key":"R37","doi-asserted-by":"publisher","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","article-title":"Harmonizing the metabolic syndrome","volume":"120","author":"Alberti","journal-title":"Circulation"},{"issue":"17","key":"R38","doi-asserted-by":"publisher","first-page":"2735","DOI":"10.1161\/CIRCULATIONAHA.105.169404","article-title":"Diagnosis and management of the metabolic syndrome","volume":"112","author":"Grundy","journal-title":"Circulation"},{"issue":"7624","key":"R39","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","article-title":"Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"335","author":"von Elm","journal-title":"BMJ"},{"issue":"6","key":"R40","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.2105\/AJPH.2016.303139","article-title":"Impact of nutrition standards on competitive food quality in Massachusetts middle and high schools","volume":"106","author":"Gorski","journal-title":"Am J Public Health"},{"issue":"4","key":"R41","doi-asserted-by":"publisher","first-page":"377","DOI":"10.4103\/ijd.ijd_1015_22","article-title":"Interleukin levels and non-alcoholic fatty liver disease in chronic plaque psoriasis: an analytical case control study","volume":"68","author":"Yadav","journal-title":"Indian J Dermatol"},{"issue":"1","key":"R42","doi-asserted-by":"publisher","DOI":"10.1038\/s41392-023-01655-6","article-title":"Signaling pathways and targeted therapies for psoriasis","volume":"8","author":"Guo","journal-title":"Signal Transduct Target Ther"},{"issue":"4","key":"R43","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1002\/oby.20121","article-title":"Treadmill desks: A 1-year prospective trial","volume":"21","author":"Koepp","journal-title":"Obesity (Silver Spring)"},{"key":"R44","doi-asserted-by":"crossref","unstructured":"Budzy\u0144ski J Szukay B . BMI as a biomarker in patients\u2019 nutritional assessment. In: Patel VB Preedy VR , editors. Biomarkers in Nutrition. Springer International Publishing; 2022:1-35. [doi: 10.1007\/978-3-030-81304-8_36-1]","DOI":"10.1007\/978-3-030-81304-8_36-1"},{"issue":"6","key":"R45","doi-asserted-by":"publisher","first-page":"1024","DOI":"10.1111\/add.16454","article-title":"Estimating causality between smoking and abdominal obesity by Mendelian randomization","volume":"119","author":"Carrasquilla","journal-title":"Addiction"},{"issue":"1","key":"R46","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1007\/s13679-014-0129-4","article-title":"Alcohol consumption and obesity: an update","volume":"4","author":"Traversy","journal-title":"Curr Obes Rep"},{"issue":"12","key":"R47","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.1080\/1744666X.2016.1201423","article-title":"Crosstalk between skin inflammation and adipose tissue-derived products: pathogenic evidence linking psoriasis to increased adiposity","volume":"12","author":"Chiricozzi","journal-title":"Expert Rev Clin Immunol"},{"key":"R48","doi-asserted-by":"publisher","DOI":"10.5114\/aoms.2016.58928","article-title":"Obesity and inflammation: the linking mechanism and the complications","volume":"4","author":"Ellulu","journal-title":"aoms"},{"issue":"1","key":"R49","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.52099","article-title":"Psoriasis and metabolic disorders: a comprehensive meta-analysis of million adults worldwide","volume":"16","author":"Alajroush","journal-title":"Cureus"}],"container-title":["JMIR Medical Informatics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/medinform.jmir.org\/2025\/1\/e75727","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:06:56Z","timestamp":1782842816000},"score":1,"resource":{"primary":{"URL":"https:\/\/medinform.jmir.org\/2025\/1\/e75727"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,23]]},"references-count":49,"URL":"https:\/\/doi.org\/10.2196\/75727","relation":{},"ISSN":["2291-9694"],"issn-type":[{"value":"2291-9694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,23]]},"article-number":"v13i3e75727"}}