Decreased circulatory levels of Vitamin D in Vitiligo: a meta-analysis

Abstract

Background The serum Vitamin D status in patients with vitiligo is ambiguous when compared to controls. A systematic review and updated meta-analysis were conducted to evaluate the association between Vitamin D and vitiligo. Methods Relevant studies were identified by searching PubMed and other databases. The random effects model was used to obtain standardized mean differences and pooled correlation coefficients. Meta-regression and sub-group analyses were conducted to explore heterogeneity. The presence of publication bias and the study robustness were tested using funnel plot and sensitivity analyses, respectively. Results This meta-analysis finally included 31 studies. Compared with controls, vitiligo patients showed significantly decreased serum Vitamin D levels (standardized mean difference = −1.03; p < 0.0001). The sub-group analysis showed that vitiligo patients with indoor/urban work had a significantly lower Vitamin D level when compared to their outdoor/rural counterparts (standardized mean differences = −0.45; p = 0.03). The sensitivity analysis indicated that no single study had a significant influence on the overall outcome, suggesting the robustness of this meta-analysis. Study limitations Varied sample sizes and heterogeneous study populations from different countries are the limitations of this study. However, the between-study heterogeneity has been addressed by the random-effects model with meta-regression and sensitivity analyses. Conclusions This meta-analysis showed significantly decreased Vitamin D level in vitiligo, and its association with indoor/outdoor type of work of vitiligo patients. This study highlights the need to assess Vitamin D status for improving its level in vitiligo.

Update on the pathogenesis of vitiligo

“…Finally, the importance of hypovitaminosis D, a modern epidemic, in the immune response regulation, as well as the effect of its supplementation as an adjunct to treatment, must be explored since patients with vitiligo have lower levels of vitamin D. 112 …”

Serum Vitamin D concentrations and their association with the clinical severity of vitiligo

“…Vitiligo is a complex alteration, product of a reduction of melanocytes of multifactorial origin, the possibility of a joint or individual participation of these factors is established, and among them we find neurogenic, autoimmune, metabolic, and self-destructive mechanisms in patients with genetic predisposition (Table 4). Several theories have been established to determine the pathophysiology of vitiligo and the processes leading to melanocyte deficiency [8].…”

“…Vitamin D is also involved in the development of melanocytes in the epidermis. Vitamin D is also involved in the development of melanocytes in the epidermis [8].…”

Alemtuzumab-Induced Secondary Autoimmune Skin Disorders as Side Effects of Multiple Sclerosis Therapy: Problem That Can Be Influenced or Fate? A Narrative Overview of The Literature A Neuroprotective Role of Vitamin D?

“…Reduced 25(OH)D levels have been largely reported in vitiligo, which is an autoimmune skin disorder characterized by the appearance of achromic macules 38 . Active vitiligo foci were observed in patients with 25(OH)D values ≤20ng/mL (deficiency) and 25(OH)D levels of 21-29ng/mL(insufficiency).…”