Amon Ulrich, Baier Laura, Yaguboglu Raul, Ennis Madeleine, Holick Michael F, Amon Julian
International Centre for Skin Diseases DermAllegra, Am Markgrafenpark 6, Pommelsbrunn-Hohenstadt, Germany.
Centre for Experimental Medicine, Queens University of Belfast, University Road, Belfast, Northern Ireland, United Kingdom.
Dermatoendocrinol. 2018 Feb 22;10(1):e1442159. doi: 10.1080/19381980.2018.1442159. eCollection 2018.
The pathogenetic role of vitamin D as well as its clinical correlation in inflammatory skin diseases is still uncertain. This study aimed to compare serum levels of 25(OH) vitamin D (calcidiol) in outpatients suffering from different skin diseases using the same laboratory method in one study. In routine serum samples of 1,532 patients from the previous 12 months we identified retrospectively 180 (mean age 49.4 years, 80 female, 100 male) and 205 (mean age 36.3 years, 116 female, 89 male) patients with psoriasis (PSO) and atopic dermatitis (AD), respectively. Clinical disease activity and quality of life was evaluated using Physicians Global Assessment Scores (PGA), Dermatology Life Quality Index (DLQI), and a Visual Analog Scale for pruritus in AD, respectively. The median 25(OH)D serum level of all patients (22.97 ng/mL, range 2.61-96.0, n = 1,461) was significantly lower in comparison to healthy controls (41.6 ng/mL, range 16.9-77.57, < 0.0001, n = 71). In PSO and AD we measured 21.05 ng/mL (44% < 20 ng/mL) and 22.7 ng/mL (39% < 20 ng/mL), respectively (p = 0.152). Among all subgroups, patients with severe acute or chronic infectious skin diseases had the lowest median 25(OH)D serum levels (17.11 ng/mL, n = 94, 66% <20 ng/mL, < 0,001 vs. AD, = 0,007 vs. PSO). For PSO and AD there was no significant correlation between 25(OH)D levels and PGA scores and DLQI values, respectively, or the extent of pruritus in AD. 25(OH)D serum levels in inflammatory skin diseases might correlate more with the type of disease and the degree of inflammation than with clinical activity itself.
维生素D在炎症性皮肤病中的致病作用及其临床相关性仍不明确。本研究旨在通过在一项研究中使用相同的实验室方法,比较不同皮肤病门诊患者的血清25(OH)维生素D(骨化二醇)水平。在对前12个月1532例患者的常规血清样本进行回顾性分析时,我们分别确定了180例(平均年龄49.4岁,女性80例,男性100例)银屑病(PSO)患者和205例(平均年龄36.3岁,女性116例,男性89例)特应性皮炎(AD)患者。分别使用医生整体评估评分(PGA)、皮肤病生活质量指数(DLQI)以及AD瘙痒视觉模拟量表对临床疾病活动度和生活质量进行评估。所有患者的血清25(OH)D中位数水平(22.97 ng/mL,范围2.61 - 96.0,n = 1461)显著低于健康对照组(41.6 ng/mL,范围16.9 - 77.57,< 0.0001,n = 71)。在PSO和AD患者中,我们分别测得21.05 ng/mL(44% < 20 ng/mL)和22.7 ng/mL(39% < 20 ng/mL)(p = 0.152)。在所有亚组中,患有严重急性或慢性感染性皮肤病的患者血清25(OH)D中位数水平最低(17.11 ng/mL,n = 94,66% <20 ng/mL,与AD相比< 0.001,与PSO相比 = 0.007)。对于PSO和AD,25(OH)D水平分别与PGA评分、DLQI值或AD瘙痒程度之间均无显著相关性。炎症性皮肤病患者的血清25(OH)D水平可能与疾病类型和炎症程度的相关性更大,而非与临床活动本身。