Hypovitaminosis D is Associated with Psoriasis: A Systematic Review and Meta-Analysis.

Siwadon Pitukweerakul, Subhanudh Thavaraputta, Sittichoke Prachuapthunyachart, Rudruidee Karnchanasorn

Journal: Kansas journal of medicine 2019;12(4):103-108

PMID: 31803350

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Plain Language Summary

Vitamin D deficiency is considered one of the risk factors for osteoporosis. In addition, hypovitaminosis D has been associated with a variety of autoimmune diseases. In fact, there is increasing evidence that psoriasis is a systemic disorder, like other inflammatory diseases. The aim of this study was to determine whether there is an association between hypovitaminosis D and psoriasis. This study is a systematic review and meta-analysis of ten studies. Results show that there is a significant relationship between low 25-hydroxyvitamin D (type of Vitamin D) levels and psoriasis. The meta-analysis revealed that the serum vitamin D level was significantly lower in psoriatic patients compared to control patients. Authors conclude that based on their findings, it would be important to measure serum 25-hydroxyvitamin D levels in psoriatic patients not only to provide supplementation but also to prevent other complications associated with vitamin D deficiency.

Abstract

INTRODUCTION

Psoriasis is a chronic inflammatory and immune-mediated skin disease that affects over 7.2 million U.S. adults. Current treatment has improved clinical outcomes. Vitamin D is believed to affect the proliferation and regeneration of keratinocytes; therefore, its deficiency is a possible risk factor; however, there is still no definite evidence. The objective of this study was to synthesize existing data on the relationship between hypovitaminosis D and psoriasis.

METHODS

A meta-analysis of relevant studies was conducted by doing a comprehensive search in the MEDLINE, EMBASE, and the Cochrane Central Register through July 2018 to identify relevant cohort studies and to assess serum 25-hydroxyvitamin D (25(OH)D) levels in adults with psoriasis. The primary outcome was the mean difference in serum 25(OH)D level between psoriatic patients and controls.

RESULTS

The initial search identified 107 articles. Only ten studies met the criteria for full-paper review. Meta-analysis was conducted from ten prospective cohort studies involving 6,217 controls and 693 cases. The pooled mean difference in serum 25(OH)D level between psoriatic patients and controls was -6.13 ng/ml (95% CI, -10.93 to -1.32, p-value = 0.01). The between-study heterogeneity (I) was 98%, p < 0.00001.

CONCLUSION

Our meta-analysis was the first study to establish the relation between vitamin D and psoriasis. The result found a significant relationship between low 25(OH) D levels and psoriasis, but did not establish a causal relationship. Further studies will be required to establish whether vitamin D supplementation benefits patients with psoriasis.

Address: University of Kansas Medical Center, Department of Internal Medicine, Division of Endocrinology, Metabolism and Genetics, Kansas City, KS.; Texas Tech University Health Sciences Center, Department of Internal Medicine, Lubbock, TX.; University of Nebraska Medical Center, Department of Pediatrics, Division of Gastroenterology, Omaha, NE.