Influence of serum lipids and polyunsaturated fatty acids on rosacea: Insights from prospective cohort studies

BACKGROUND AND OBJECTIVES: Recent studies have suggested potential links between dermatological conditions, dyslipidemia, and cardiovascular health, yet the relationship between serum lipids and rosacea remains uncertain. PATIENTS AND METHODS: Utilizing data from UK Biobank, we employed Cox proportional hazard models to evaluate the correlation between rosacea and serum lipids, with mediation analysis further elucidating the underlying mechanisms. Additionally, two-sample Mendelian randomization and linkage disequilibrium score regression were performed to determine the genetic association. RESULTS: In both the blood biochemistry cohort and the nuclear magnetic resonance metabolome cohort, higher levels of total cholesterol, LDL, and cholesterol in large LDL were inversely associated with rosacea (HR = 0.90 [0.85-0.95], 0.91 [0.86-0.96], and 0.90 [0.85-0.95], respectively). Additionally, omega-3 was found to potentially reduce the risk of rosacea by increasing cholesterol levels in large LDL (OR = 0.88 [0.82-0.94]; mediated proportion = 61.56%). Mendelian randomization analyses further supported the protective effects of total cholesterol and cholesterol in large LDL against rosacea (OR = 0.70 [0.55-0.89] and 0.79 [0.62-0.99], respectively). CONCLUSIONS: These findings suggest that higher levels of total cholesterol and cholesterol in large LDL may decrease rosacea risk, while omega-3 could influence rosacea pathogenesis through modulation of cholesterol in large LDL.