一项评估 25 羟基维生素 D 水平在寻常型白癜风患者中作用的初步研究。

A pilot study assessing the role of 25 hydroxy vitamin D levels in patients with vitiligo vulgaris.

机构信息

Department of Pathology, Center for Allergy and Asthma Research, SUNY, and Downstate Medical Center, Brooklyn, New York, USA.

出版信息

J Am Acad Dermatol. 2010 Jun;62(6):937-41. doi: 10.1016/j.jaad.2009.11.024.

DOI:10.1016/j.jaad.2009.11.024

PMID:20466170

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).

摘要

背景

多种自身免疫性疾病患者的维生素 D 水平非常低。

目的

确定在寻常型白癜风患者中，低维生素 D 水平是否与自身免疫有关。

方法

对 45 例连续寻常型白癜风患者进行前瞻性队列研究。在研究入组时采集血清，测定 25-羟维生素 D 水平。对 25-羟维生素 D 水平与疾病状态的关系进行 logistic 回归分析，包括皮损面积、近期发病的白癜风、Fitzpatrick 皮肤类型和种族、乳制品摄入量、个人和家族自身免疫史。建立多个单变量和多变量 logistic 回归模型，以评估这些参数的相互关系。

结果

25-羟维生素 D 水平分为 3 组：31.1%正常（＞30ng/ml），55.6%不足（＜30ng/ml），13.3%非常低（＜15ng/ml）。不足的 25-羟维生素 D 水平与 Fitzpatrick 光型增加相关（比值比[OR] = 1.76，95%置信区间[CI] = 1.12-2.77）。非常低的 25-羟维生素 D 水平与合并自身免疫性疾病相关（OR = 10.00，95%CI = 1.06-94.7），但与年龄、性别、种族/民族、白癜风或自身免疫性疾病家族史、新发疾病或皮损面积无关。调查的患者均无报告每天摄入大于 200IU 的维生素 D。