Dogru M
Health Sciences University, Zeynep Kamil Woman and Children Health Practice and Research Center, Department of Pediatrics, Istanbul, Turkey.
Allergol Immunopathol (Madr). 2018 Nov-Dec;46(6):546-551. doi: 10.1016/j.aller.2017.12.004. Epub 2018 Mar 17.
Atopic dermatitis (AD) is a chronic inflammatory disease of the skin. Apart from its well-known role on calcium metabolism, vitamin D is reported to affect skin functions. The study aims were to: compare the vitamin D levels of children with AD and healthy children; investigate the relationship between the severity of AD and vitamin D levels; and investigate the effect of vitamin D on the natural course of AD.
Sixty-nine patients with AD were enrolled. Seventy healthy children were assigned as control group. Clinical and demographic features of groups were recorded. The skin prick test, eosinophil counts, immunoglobulin (Ig) E levels and serum 25 OH cholecalciferol (25OHD3) levels were measured. After at least 4 years of follow-up, patients were re-evaluated for natural course of AD.
Mean 25OHD3 level was lower in patient group vs. control group; 19.86±6.7ng/mL (min-max: 6.8-40) vs. 24.07±9.08ng/mL, respectively, (p=0.002). Mean 25OHD3 levels, and vitamin D status were significantly different between AD severity groups. (p<0.05). In terms of vitamin D status in the pairwise comparison, vitamin D deficiency was greater in children with severe and moderate AD groups (respectively, p=0.005, p=0.018). In Tukey's post hoc analysis for 25OHD3 level, the 25OHD3 levels of severe AD are significantly lower than mild or moderate AD (respectively, p=0.001, p=0.026). There was a negative correlation between 25OHD3 levels and severity of AD (r=-0.480; p=0.001). In patients reassessed after 4 years: age, the age of AD onset, vitamin D deficiency, SCORAD level and severe AD were higher in the persistent group vs. remission group, 25OHD3 levels were higher in the remission group vs. persistent group (p<0.05).
Mean vitamin D levels were lower in patients with AD. A negative correlation between vitamin D levels and disease severity was documented. Vitamin D may affect the natural course of atopic dermatitis. There is a need for more comprehensive studies in this regard.
特应性皮炎（AD）是一种慢性皮肤炎症性疾病。除了其在钙代谢方面的知名作用外，据报道维生素D还会影响皮肤功能。本研究的目的是：比较AD患儿与健康儿童的维生素D水平；研究AD严重程度与维生素D水平之间的关系；以及研究维生素D对AD自然病程的影响。
招募了69例AD患者。70名健康儿童被分配为对照组。记录两组的临床和人口统计学特征。进行皮肤点刺试验、嗜酸性粒细胞计数、免疫球蛋白（Ig）E水平和血清25-羟基胆钙化醇（25OHD3）水平的检测。经过至少4年的随访后，对患者AD的自然病程进行重新评估。
患者组的平均25OHD3水平低于对照组；分别为19.86±6.7ng/mL（最小值-最大值：6.8-40）和24.07±9.08ng/mL，（p=0.002）。AD严重程度组之间的平均25OHD3水平和维生素D状态存在显著差异。（p<0.05）。在两两比较的维生素D状态方面，重度和中度AD组儿童的维生素D缺乏情况更为严重（分别为p=0.005，p=0.018）。在对25OHD3水平进行的Tukey事后分析中，重度AD的25OHD3水平显著低于轻度或中度AD（分别为p=0.001，p=0.026）。25OHD3水平与AD严重程度之间存在负相关（r=-0.480；p=0.001）。在4年后重新评估的患者中：持续组的年龄、AD发病年龄、维生素D缺乏、SCORAD水平和重度AD均高于缓解组，缓解组的25OHD3水平高于持续组（p<0.05）。
AD患者的平均维生素D水平较低。记录到维生素D水平与疾病严重程度之间存在负相关。维生素D可能会影响特应性皮炎的自然病程。在这方面需要进行更全面的研究。
