Taneja Kanchan, Taneja Jitendra, Kaur Charanjeet, Patel Seema, Haldar Deepa
Clin Lab. 2020 Oct 1;66(10). doi: 10.7754/Clin.Lab.2020.200120.
Vitiligo is an acquired, depigmenting skin disease with unclear, multifactorial etiopathogenesis affecting not only skin but also connected with metabolic abnormalities, including glucose and lipid abnormalities, confirming the systemic nature of the disease. Vitamin B12 and folic acid deficiencies have also been implicated in vitiligo that can lead to increased homocysteine levels in the circulation, a finding that can be expected in vitiligo. Further, an association between hyperlipidemia and hyperhomocysteinemia has been suggested in vitiligo patients showing the eminent need of management of vascular risk factors especially in diseases with metabolic abnormalities. The present study was thus aimed to assess homocysteine levels and lipid risk factors in vitiligo patients and to study their interrelationship to predict the cardiometabolic risk in vitiligo and its management.
The present cross-sectional study included 54 case of generalized vitiligo and 54 age and gender-matched healthy adults as controls. Patients were assessed for disease activity and severity (VASI Score). All the subjects were evaluated for the lipid profile and serum homocysteine levels.
Lipid profile analysis showed significantly higher LDL-cholesterol concentration (p = 0.010), significantly lower HDL-cholesterol concentration (p = 0.003) and significantly higher LDL/HDL ratio (p = 0.001) in patients with vitiligo in comparison with the control group. The mean serum homocysteine levels in vitiligo patients (18.76 ± 10.02 µmol/L) were significantly higher than in controls (10.04 ± 5.34 μmol/L) (p = 0.000). Serum homocysteine levels showed a positive correlation with the duration of disease which was near to significant (p = 0.064) and VASI score (p = 0.000). No significant correlation was observed between serum Hcy levels and lipid profile.
The present study showed significantly higher Hcy levels in vitiligo patients than controls which may be a precipitating factor in the pathogenesis of vitiligo in predisposed individuals. The results of our study are also indicative of lipid disturbances in vitiligo. These findings may reflect some ongoing abnormal metabolic processes in patients with vitiligo. Therefore, we recommend routine estimation of homocysteine and lipid profile in vitiligo patients both of which should be regarded as independent significant contributing factors of cardiometabolic risk worth considering in the management of patients with vitiligo.
白癜风是一种后天性色素脱失性皮肤病，其发病机制不明，涉及多种因素，不仅影响皮肤，还与代谢异常有关，包括血糖和脂质异常，这证实了该疾病的系统性。维生素B12和叶酸缺乏也与白癜风有关，这可能导致循环中同型半胱氨酸水平升高，这在白癜风患者中是可以预期的发现。此外，在白癜风患者中已表明存在高脂血症与高同型半胱氨酸血症之间的关联，这表明尤其在患有代谢异常的疾病中，迫切需要对血管危险因素进行管理。因此，本研究旨在评估白癜风患者的同型半胱氨酸水平和脂质危险因素，并研究它们之间的相互关系，以预测白癜风患者的心脏代谢风险及其管理。
本横断面研究纳入了54例泛发性白癜风患者以及54例年龄和性别匹配的健康成年人作为对照。对患者的疾病活动度和严重程度（白癜风面积评分指数[VASI]）进行评估。对所有受试者的血脂谱和血清同型半胱氨酸水平进行评估。
血脂谱分析显示，与对照组相比，白癜风患者的低密度脂蛋白胆固醇浓度显著更高（p = 0.010），高密度脂蛋白胆固醇浓度显著更低（p = 0.003），低密度脂蛋白/高密度脂蛋白比值显著更高（p = 0.001）。白癜风患者的血清同型半胱氨酸平均水平（18.76±10.02μmol/L）显著高于对照组（10.04±5.34μmol/L）（p = 0.000）。血清同型半胱氨酸水平与疾病持续时间呈正相关，接近显著水平（p = 0.064），与VASI评分呈正相关（p = 0.000）。血清同型半胱氨酸水平与血脂谱之间未观察到显著相关性。
本研究表明，白癜风患者的同型半胱氨酸水平显著高于对照组患者，这可能是易感个体白癜风发病机制中的一个促发因素。我们的研究结果也表明白癜风患者存在脂质紊乱。这些发现可能反映了白癜风患者中一些正在进行的异常代谢过程。因此，我们建议对白癜风患者进行同型半胱氨酸和血脂谱的常规评估，这两者均应被视为心脏代谢风险的独立重要促成因素，在白癜风患者的管理中值得考虑。
