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A pilot study assessing the role of 25 hydroxy vitamin D levels in patients with vitiligo vulgaris - 24/04/13

Doi : 10.1016/j.jaad.2009.11.024 
Jonathan I. Silverberg, MD, PhD, MPH a, Arnold I. Silverberg, MD b, Edmond Malka, MPH, CPH, CSci, CChem, MRSC, FAIC c, Nanette B. Silverberg, MD d,
a Department of Pathology, Center for Allergy and Asthma Research, SUNY, and Downstate Medical Center, Brooklyn, New York 
b Division of Endocrinology and Metabolism, Department of Medicine, Maimonides Medical Center, Brooklyn, New York 
c Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, New Jersey 
d Department of Dermatology, St. Luke’s-Roosevelt Hospital Center, New York, New York 

Reprint requests: Nanette B. Silverberg, MD, Department of Dermatology, St. Luke’s-Roosevelt Hospital Center, 1090 Amsterdam Ave, Suite 11D, New York, NY 10025.

See commentary on page 942

Abstract

Background

Very low vitamin D levels have been noted in patients with a variety of autoimmune diseases.

Objective

To determine whether low vitamin D levels are associated with autoimmunity in the setting of vitiligo vulgaris.

Methods

A prospective cohort study was conducted on 45 consecutive patients with vitiligo vulgaris. 25-Hydroxyvitamin D levels were determined from sera collected at the time of study enrollment. Logistic regression analysis of the relationship of 25-hydroxyvitamin D levels to disease state was performed, including surface area, recent-onset vitiligo, Fitzpatrick skin type and ethnicity, dairy intake, and both personal and family history of autoimmunity. Multiple univariate and multivariate logistic regression models were developed to assess the interrelationship of these parameters.

Results

25-Hydroxyvitamin D levels were divided into 3 groups: 31.1% were normal (>30 ng/mL), 55.6% were insufficient (<30 ng/mL), and 13.3% were very low (<15 ng/mL). Insufficient 25-hydroxyvitamin D levels were associated with increasing Fitzpatrick phototypes (odds ratio [OR] = 1.76, 95% confidence interval [CI] = 1.12-2.77). Very low 25-hydroxyvitamin D levels were associated with comorbid autoimmune illness (OR = 10.00, 95% CI = 1.06-94.7), but not with age, gender, race/ethnicity, family history of vitiligo or autoimmune disease, new-onset disease, or body surface area affected. None of the surveyed patients reported daily vitamin D intake of greater than 200 IU.

Limitations

This study consists of a small cohort that assesses point prevalence without assessing seasonal variation in vitamin D levels.

Conclusions

Very low 25-hydroxyvitamin D levels (<15 ng/mL) appear to be a reasonable screening tool for the presence of comorbid autoimmunity. Furthermore, we demonstrate that Fitzpatrick phototype, rather than ethnicity, is specifically associated with 25-hydroxyvitamin D levels that are insufficient (<30 ng/mL).

Le texte complet de cet article est disponible en PDF.

Key words : autoimmunity, hypopigmentation, 25 (OH) vitamin D, vitiligo vulgaris

Abbreviations used : 25(OH)D, BSA, CI, OR, VV


Plan


 Funding sources: None.
 Conflicts of interest: None declared.


© 2009  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 62 - N° 6

P. 937-941 - juin 2010 Retour au numéro
Article précédent Article précédent
  • Commentary: Ultraviolet irradiation and oral ingestion as sources of optimal vitamin D
  • William G. Tsiaras, Martin A. Weinstock
| Article suivant Article suivant
  • Commentary: Vitamin D and autoimmunity : Is there an association?
  • Sibel Ersoy-Evans

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