Background and Aim: The mean platelet volume to lymphocyte ratio (MPVLR) has been proposed as a novel clinical marker that appears to offer enhanced utility in comparison to conventional single blood cell markers in the assessment of disease. This study aims to investigate the relationship between MPVLR and Psoriasis (PsO). Methods: A cross-sectional study was conducted using data from 14,390 participants in the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2014. Utilising the mean platelet volume to lymphocyte ratio (MPVLR) as the primary exposure, we employed multivariate regression models to assess the association between MPVLR and the risk of psoriasis, and performed subgroup analyses across different age groups. We further employed interaction tests to assess the moderating effect of age on the MPVLR-PsO association. In order to explore potential nonlinear relationships and threshold effects, the present study combined curve fitting with threshold (inflection point K) analysis and evaluated the goodness of fit of the segmented models using model comparison (log-likelihood ratio tests). Results: MPVLR was positively associated with the odds of psoriasis. This association showed a consistent direction across age strata, with no significant age-modifying effect in interaction tests. In the 40 - 59 age group, below the threshold of 3.25, each one-unit increase in MPVLR was associated with a 133% increase in the risk of psoriasis; in the ≥60 years group, below the threshold of 8.46, each one-unit increase in MPVLR was associated with a 21% increase in the risk of psoriasis. Conclusions: In summary, an elevated MPVLR has been demonstrated to be associated with increased odds of psoriasis, and this relationship exhibits certain age-related nonlinear threshold characteristics. This may provide clinicians with supplementary data to aid in the early diagnosis of psoriasis.
References
[1]
Walter, K. (2022) Psoriasis. JAMA, 327, 1936. https://doi.org/10.1001/jama.2022.5270
[2]
Orlando, G., Molon, B., Viola, A., Alaibac, M., Angioni, R. and Piaserico, S. (2022) Psoriasis and Cardiovascular Diseases: An Immune-Mediated Cross Talk? Frontiers in Immunology, 13, Article 868277. https://doi.org/10.3389/fimmu.2022.868277
[3]
Brazzelli, V., Maffioli, P., Bolcato, V., Ciolfi, C., D’Angelo, A., Tinelli, C., et al. (2021) Psoriasis and Diabetes, a Dangerous Association: Evaluation of Insulin Resistance, Lipid Abnormalities, and Cardiovascular Risk Biomarkers. Frontiers in Medicine, 8, Article 605691. https://doi.org/10.3389/fmed.2021.605691
[4]
Hao, Y., Zhu, Y.J., Zou, S., Zhou, P., Hu, Y.W., Zhao, Q.X., et al. (2021) Metabolic Syndrome and Psoriasis: Mechanisms and Future Directions. Frontiers in Immunology, 12, Article 711060. https://doi.org/10.3389/fimmu.2021.711060
[5]
Smith, B., Kim, Y.J. and Tung, J.K. (2025) Psoriasis Prevalence among Adults in the United States. Journal of the American Academy of Dermatology, 92, 917-919. https://doi.org/10.1016/j.jaad.2024.12.002
[6]
Reid, C. and Griffiths, C. (2020) Psoriasis and Treatment: Past, Present and Future Aspects. Acta Dermato Venereologica, 100, 70-80. https://doi.org/10.2340/00015555-3386
[7]
Egan, B.M. and Zhao, Y. (2012) Different Definitions of Prevalent Hypertension Impact: The Clinical Epidemiology of Hypertension and Attainment of Healthy People Goals. The Journal of Clinical Hypertension, 15, 154-161. https://doi.org/10.1111/jch.12057
[8]
Cosentino, F., Grant, P.J., Aboyans, V., Bailey, C.J., Ceriello, A., Delgado, V., et al. (2020) 2019 ESC Guidelines on Diabetes, Pre-Diabetes, and Cardiovascular Diseases Developed in Collaboration with the EASD. European Heart Journal, 41, 255-323. https://doi.org/10.1093/eurheartj/ehz486
[9]
ElSayed, N.A., McCoy, R.G., Aleppo, G., Balapattabi, K., Beverly, E.A., Briggs Early, K., et al. (2025) 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2025. Diabetes Care, 48, S27-S49. https://doi.org/10.2337/dc25-s002
[10]
National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) (2002) Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report. Circulation, 106, 3143-3421.
[11]
Xiong, J., Xue, T., Tong, M., Xu, L. and Bai, B. (2025) Dynamic Trend Analysis of Global Psoriasis Burden from 1990 to 2021: A Study of Gender, Age, and Regional Differences Based on GBD 2021 Data. Frontiers in Public Health, 13, Article 1518681. https://doi.org/10.3389/fpubh.2025.1518681
[12]
Yamazaki, F. (2021) Psoriasis: Comorbidities. The Journal of Dermatology, 48, 732-740. https://doi.org/10.1111/1346-8138.15840
[13]
Awadh, N., Gorial, F., Hammadi, R., Ibrahim, M., Majeed, S. and Mohammed, M. (2022) Mean Platelet Volume to Lymphocyte Ratio and Platelet Distribution Width to Lymphocyte Ratio in Iraqi Patients Diagnosed with Systemic Lupus Erythematosus. Rheumatology, 60, 173-182. https://doi.org/10.5114/reum.2022.117837
[14]
？yczkowski, M., Kaletka, Z., Rajwa, P., Rempega, G., Stelmach, P., Bogacki, R., et al. (2020) Mean Platelet Volume-to-Lymphocyte Ratio: A Novel Biomarker Associated with Overall Survival in Patients with Nonmetastatic Clear Cell Renal Cell Carcinoma Treated with Nephrectomy. International Urology and Nephrology, 52, 885-891. https://doi.org/10.1007/s11255-020-02379-0
[15]
Wu, F., Wang, Q., Qiao, Y., Yu, Q. and Wang, F. (2022) A New Marker of Short-Term Mortality and Poor Outcome in Patients with Acute Ischemic Stroke: Mean Platelet Volume-to-Lymphocyte Ratio. Medicine, 101, e30911. https://doi.org/10.1097/md.0000000000030911
[16]
Hudzik, B., Szkodziński, J., Lekston, A., Gierlotka, M., Poloński, L. and G？sior, M. (2016) Mean Platelet Volume-to-Lymphocyte Ratio: A Novel Marker of Poor Short-and Long-Term Prognosis in Patients with Diabetes Mellitus and Acute Myocardial Infarction. Journal of Diabetes and Its Complications, 30, 1097-1102. https://doi.org/10.1016/j.jdiacomp.2016.04.010
[17]
Kurtul, A. and Acikgoz, S.K. (2017) Usefulness of Mean Platelet Volume-to-Lymphocyte Ratio for Predicting Angiographic No-Reflow and Short-Term Prognosis after Primary Percutaneous Coronary Intervention in Patients with St-Segment Elevation Myocardial Infarction. The American Journal of Cardiology, 120, 534-541. https://doi.org/10.1016/j.amjcard.2017.05.020
[18]
Xu, B., Zhang, Y., Chen, G., Feng, J. and Gan, L. (2022) Association of Mean Platelet Volume/Lymphocyte Ratio with Inflammation in Non-Dialysis Patients with Chronic Kidney Disease Stages 1-4: A Retrospective Study. Frontiers in Immunology, 13, Article 1041356. https://doi.org/10.3389/fimmu.2022.1041356
[19]
Chavez Velasquez, D., Guzman Ventura, W., Chavez Velasquez, A., Hameed, A., Chavez Velasquez, R. and Jose, T. (2024) Mean Platelet Volume Lymphocyte Ratio: Could It Be a Game-Changer for Early Detection of Diabetic Nephropathy?—A Diagnostic Test Study. Blood, 144, 5399-5399. https://doi.org/10.1182/blood-2024-211886
[20]
Scherlinger, M., Richez, C., Tsokos, G.C., Boilard, E. and Blanco, P. (2023) The Role of Platelets in Immune-Mediated Inflammatory Diseases. Nature Reviews Immunology, 23, 495-510. https://doi.org/10.1038/s41577-023-00834-4
[21]
Yamanaka, K., Yamamoto, O. and Honda, T. (2021) Pathophysiology of Psoriasis: A Review. The Journal of Dermatology, 48, 722-731. https://doi.org/10.1111/1346-8138.15913
[22]
Hawkes, J.E., Chan, T.C. and Krueger, J.G. (2017) Psoriasis Pathogenesis and the Development of Novel Targeted Immune Therapies. Journal of Allergy and Clinical Immunology, 140, 645-653. https://doi.org/10.1016/j.jaci.2017.07.004
[23]
Lowes, M.A., Kikuchi, T., Fuentes-Duculan, J., Cardinale, I., Zaba, L.C., Haider, A.S., et al. (2008) Psoriasis Vulgaris Lesions Contain Discrete Populations of Th1 and Th17 T Cells. Journal of Investigative Dermatology, 128, 1207-1211. https://doi.org/10.1038/sj.jid.5701213
[24]
Serebryanaya, N.B., Shanin, S.N., Fomicheva, E.E. and Yakutseni, P.P. (2019) Blood Platelets as Activators and Regulators of Inflammatory and Immune Reactions. Part 2. Thrombocytes as Participants of Immune Reactions. Medical Immunology (Russia), 21, 9-20. https://doi.org/10.15789/1563-0625-2019-1-9-20
[25]
Ludwig, R.J., Schultz, J.E., Boehncke, W., Podda, M., Tandi, C., Krombach, F., et al. (2004) Activated, Not Resting, Platelets Increase Leukocyte Rolling in Murine Skin Utilizing a Distinct Set of Adhesion Molecules. Journal of Investigative Dermatology, 122, 830-836. https://doi.org/10.1111/j.0022-202x.2004.22318.x
[26]
Tamagawa-Mineoka, R., Katoh, N., Ueda, E., Takenaka, H., Kita, M. and Kishimoto, S. (2007) The Role of Platelets in Leukocyte Recruitment in Chronic Contact Hypersensitivity Induced by Repeated Elicitation. The American Journal of Pathology, 170, 2019-2029. https://doi.org/10.2353/ajpath.2007.060881
