Background and Aims The prevalence of psoriasis (Pso), a chronic immune‐mediated inflammatory skin disease, is high in patients with obesity. This study investigates the mediating role of the systemic immune‐inflammation index (SII) in the association between body roundness index (BRI) and Pso prevalence. Methods and Results This study included 14,669 participants from the National Health and Nutrition Examination Survey (NHANES) (2003–2006, 2009−2014). The presence or absence of obesity was identified using the BRI, and Pso was assessed using the Pso questionnaire. The association of BRI with Pso was explored by weighted multivariate logistic regression analyses and restricted cubic spline (RCS) analyses, and the threshold effect was further examined using two‐stage linear regression models. Mediation analyses assessed SII’s role in the BRI‐Pso association. The Pso group included 445 out of 14,669 participants. Logistic regression analyses indicated a positive association between BRI and Pso after adjusting for potential confounders. RCS analyses showed a nonlinear relation between BRI and Pso ( P nonlinear = 0.018), with a point of inflection at 5.103 (odds ratio OR = 1.09, 95% CI: 1.04, 1.14). BRI and Pso were positively correlated on the left side of the point of inflection (OR = 1.25, 95% CI: 1.09, 1.45), whereas such an association was not detected on the right side (OR = 1.04, 95% CI: 0.97, 1.11). Mediation analysis showed SII partially mediated this association, accounting for 9.48% of the effect ( p < 0.001). Conclusion BRI is positively associated with Pso, with SII playing a mediating role. These findings highlight the importance of visceral fat management and SII monitoring in addressing Pso and its metabolic comorbidities.
Zhang et al. (Thu,) studied this question.