Abstract
BACKGROUND: The composite dietary antioxidant index (CDAI) is an effective indicator to evaluate the comprehensive intake of dietary antioxidants in individuals. There is growing evidence suggesting that higher CDAI levels are associated with a reduced risk of diverse health conditions such as hypertension and atherosclerotic cardiovascular disease, as well as with lower mortality risk among the general public. However, its impact on the mortality risk of patients with psoriasis remains unclear. This study aimed to investigate the potential association between CDAI and the risk of death in individuals with psoriasis. METHODS: Data extracted from the National Health and Nutrition Examination Survey (NHANES) spanning 2003-2006 and 2009-2014 was enrolled in this research, with mortality data obtained from the National Death Index (NDI) database. We utilized Multivariate COX proportional hazard regression models to investigate the influence of CDAI levels on the death risk from all causes among individuals with psoriasis. We further performed subgroup and sensitivity analyses to verify the reliability of the results. RESULTS: Five hundred patients with psoriasis were finally enrolled in this prospective study. During the follow-up period, 61 deaths occurred. CDAI levels were linked to a reduced death risk in patients with psoriasis, compared to the lowest tertile, the hazard ratios for all-cause mortality were 0.48 (95% CI: 0.20-1.17, P = 0.105) for tertile 2 and 0.30 (95% CI: 0.12-0.74, P = 0.009) for tertile 3. CONCLUSION: Our study found that higher CDAI levels were associated with lower all-cause mortality in patients with psoriasis. Further prospective studies are needed to confirm the role of CDAI in mortality risk in patients with psoriasis.