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中重度痤疮患者的维生素 D 水平:一项口服异维 A 酸治疗的病例对照研究及前瞻性研究。

Vitamin D level in patients with moderate-to-severe acne: A case-control study combined with prospective study following oral isotretinoin treatment.

机构信息

Department of Dermatology and Venereology, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.

Department of Biochemistry, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.

出版信息

J Cosmet Dermatol. 2022 Oct;21(10):5127-5133. doi: 10.1111/jocd.14996. Epub 2022 May 10.

Abstract

BACKGROUND

Vitamin D may have an important role in the pathogenesis of acne vulgaris (AV) as it has an immunomodulatory effect and regulates the proliferation and differentiation of keratinocytes. Oral isotretinoin used in the management of moderate-to-severe acne binds to the retinoid receptor which can form a heterodimer with vitamin D receptor (VDR) and may decrease the level of vitamin D by increasing catabolism. Two studies published so far investigating the effect of oral isotretinoin on serum vitamin D level are contradictory to one another.

OBJECTIVE

This study aimed to compare the serum vitamin D levels in patients with moderate-to-severe acne and age- and sex-matched healthy controls and to determine the serum level of vitamin D in patients with moderate-to-severe acne following 3 months of oral isotretinoin treatment.

METHODS

A total of 120 patients with moderate-to-severe acne and 90 age- and sex-matched healthy controls were enrolled in the study. The patients were treated with oral isotretinoin at 0.50-0.75 mg/kg/day and serum vitamin D was measured at baseline and 3 months after the treatment.

RESULT

Serum vitamin D was insufficient and deficient in 90.50% of cases in comparison with 43.33% of controls (p = 0.001). Serum vitamin D had an inverse correlation with the severity of acne. Following 3 months of oral isotretinoin, there was no significant change in serum vitamin D level (p = 0.127).

CONCLUSION

Vitamin D was low in patients with moderate-to-severe acne in compared with control. Vitamin D level did not change with short-term therapy with oral Isotretinoin.

摘要

背景

维生素 D 可能在寻常痤疮(AV)的发病机制中起重要作用,因为它具有免疫调节作用,并调节角质形成细胞的增殖和分化。用于治疗中重度痤疮的口服异维 A 酸与视黄醇受体结合,可与维生素 D 受体(VDR)形成异二聚体,并通过增加分解代谢来降低维生素 D 水平。迄今为止发表的两项研究表明,口服异维 A 酸对血清维生素 D 水平的影响相互矛盾。

目的

本研究旨在比较中重度痤疮患者与年龄和性别匹配的健康对照者的血清维生素 D 水平,并确定中重度痤疮患者在口服异维 A 酸治疗 3 个月后的血清维生素 D 水平。

方法

共纳入 120 例中重度痤疮患者和 90 例年龄和性别匹配的健康对照者。患者接受口服异维 A 酸治疗,剂量为 0.50-0.75mg/kg/天,并在基线和治疗 3 个月后测量血清维生素 D 水平。

结果

与对照组的 43.33%相比,血清维生素 D 不足和缺乏的比例在病例中为 90.50%(p=0.001)。血清维生素 D 与痤疮的严重程度呈负相关。口服异维 A 酸治疗 3 个月后,血清维生素 D 水平无显著变化(p=0.127)。

结论

与对照组相比,中重度痤疮患者的维生素 D 水平较低。短期口服异维 A 酸治疗不会改变维生素 D 水平。

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