Serum Vitamin D Levels Not Associated with Atopic Dermatitis Severity

Robl, Renata; Uber, Marjorie; Abagge, Kerstin Taniguchi; Cat, Mônica Nunes Lima; Carvalho, Vânia Oliveira

doi:10.1111/pde.12795

Cited by 26 publications

(24 citation statements)

References 18 publications

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“…Our findings for atopic dermatitis and IgE agree with recent observational studies and RCTs [3,4,9]. In contrast, we have used the same methods to provide evidence supporting a causal role for 25OHD in risk of multiple sclerosis [41].…”

Section: Discussionsupporting

confidence: 88%

Vitamin D levels and susceptibility to asthma, elevated immunoglobulin E levels, and atopic dermatitis: A Mendelian randomization study

et al. 2017

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BackgroundLow circulating vitamin D levels have been associated with risk of asthma, atopic dermatitis, and elevated total immunoglobulin E (IgE). These epidemiological associations, if true, would have public health importance, since vitamin D insufficiency is common and correctable.Methods and findingsWe aimed to test whether genetically lowered vitamin D levels were associated with risk of asthma, atopic dermatitis, or elevated serum IgE levels, using Mendelian randomization (MR) methodology to control bias owing to confounding and reverse causation. The study employed data from the UK Biobank resource and from the SUNLIGHT, GABRIEL and EAGLE eczema consortia. Using four single-nucleotide polymorphisms (SNPs) strongly associated with 25-hydroxyvitamin D (25OHD) levels in 33,996 individuals, we conducted MR studies to estimate the effect of lowered 25OHD on the risk of asthma (n = 146,761), childhood onset asthma (n = 15,008), atopic dermatitis (n = 40,835), and elevated IgE level (n = 12,853) and tested MR assumptions in sensitivity analyses. None of the four 25OHD-lowering alleles were associated with asthma, atopic dermatitis, or elevated IgE levels (p ≥ 0.2). The MR odds ratio per standard deviation decrease in log-transformed 25OHD was 1.03 (95% confidence interval [CI] 0.90–1.19, p = 0.63) for asthma, 0.95 (95% CI 0.69–1.31, p = 0.76) for childhood-onset asthma, and 1.12 (95% CI 0.92–1.37, p = 0.27) for atopic dermatitis, and the effect size on log-transformed IgE levels was −0.40 (95% CI −1.65 to 0.85, p = 0.54). These results persisted in sensitivity analyses assessing population stratification and pleiotropy and vitamin D synthesis and metabolism pathways. The main limitations of this study are that the findings do not exclude an association between the studied outcomes and 1,25-dihydoxyvitamin D, the active form of vitamin D, the study was underpowered to detect effects smaller than an OR of 1.33 for childhood asthma, and the analyses were restricted to white populations of European ancestry. This research has been conducted using the UK Biobank Resource and data from the SUNLIGHT, GABRIEL and EAGLE Eczema consortia.ConclusionsIn this study, we found no evidence that genetically determined reduction in 25OHD levels conferred an increased risk of asthma, atopic dermatitis, or elevated total serum IgE, suggesting that efforts to increase vitamin D are unlikely to reduce risks of atopic disease.

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Section: Discussionsupporting

confidence: 88%

Vitamin D levels and susceptibility to asthma, elevated immunoglobulin E levels, and atopic dermatitis: A Mendelian randomization study

et al. 2017

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“…Dark phototypes have not been previously associated with lower AD prevalence Regarding AD severity, patients with more severe forms tended to have lower serum 25(OH)D levels, although these were not statistically significant. These results are not supported by the findings of several studies, although others have reported a significant inverse correlation . Few studies have considered the influence of phototype when investigating this relationship .…”

Section: Discussioncontrasting

confidence: 68%

“…All of these functions support its role in the pathophysiology of AD . While low serum levels of VD have been linked to AD severity in certain populations, these findings have not been replicated in others . Therefore, the evidence to support the improvement of AD with VD supplementation is still weak …”

Section: Introductionmentioning

confidence: 99%

The association between atopic dermatitis and serum 25‐hydroxyvitamin D in children: Influence of sun exposure, diet, and atopy features—A cross‐sectional study

Sanmartín¹,

Pardos

Doste³

et al. 2020

Pediatric Dermatology

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Background Previous studies have linked low serum vitamin D (VD) or 25‐hydroxyvitamin D (25(OH)D) levels with increased severity of atopic dermatitis (AD) in children. Objective To investigate the association between serum VD (25(OH)D) levels and AD and AD severity, considering the influence of diet and sun exposure. Methods We performed a prospective cross‐sectional study of healthy controls and children diagnosed with AD. Participants were recruited between January 2011 and December 2012, and the following parameters were assessed: age, sex, body mass index (BMI), AD severity, Fitzpatrick skin type, asthma and rhinitis history, dietary VD intake, daily potential sun‐induced VD production, sunscreen use, 25(OH)D and IgE serum levels, and results of the ImmunoCAP Phadiatop Infant test. Results The study population consisted of 105 healthy controls and 134 AD patients. Serum 25(OH)D levels were significantly lower in moderate and severe AD than in mild AD, although this association was only significant for patients with light Fitzpatrick skin type (mean(SD) 36.7 (11.9) ng/mL; moderate 28.8 [11.5] ng/mL; and severe 27.6 [12.1] ng/mL, P = .045). Logistic regression analysis revealed a positive association between severe AD and both positive ImmunoCAP Phadiatop test and BMI. Conclusion Our data support an association between VD deficiency and AD severity only in patients with light complexion.

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“…Moreover, in other studies, the correlations of low vitamin D with SCORAD, allergic sensitization, and high IgE were noted, but we did not find such associations. The recent publications also denied the thesis, that serum vitamin D concentrations were significantly related to AD severity . The role of vitamin D in immunoregulation, involving pro‐inflammatory cytokine synthesis, has been well described .…”

Section: Discussionmentioning

confidence: 99%

Association of antioxidants and vitamin D level with inflammation in children with atopic dermatitis

et al. 2019

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Background Changing the resources of vitamin D and antioxidant nutrients may affect the course of allergic diseases. The aim of the study was to investigate the association between CoQ10, vitamin D, retinol, and α‐tocopherol serum levels and severity of atopic dermatitis (AD) in children. Methods Twenty‐nine children with AD aged from 1 to 15 years were enrolled into the study. The severity of AD was categorized into mild or moderate (≤50 points in SCORAD – Scoring Atopic Dermatitis index) and severe (>50 SCORAD points). The control group was comprised of 22 children with negative history of allergy aged from 2 to 15. The serum measurements included vitamin D, retinol, α‐tocopherol, CoQ10, C‐reactive protein (CRP), complete blood count (CBC), and total immunoglobulin E (IgE). Results Low vitamin D concentration (<20 ng/ml) was observed mainly in patients with severe AD (77.8%), compared to children with mild or moderate AD (25%) or the control group (31.8%). Concentration of retinol was decreased significantly in patients with severe AD (median 1.32 μmol/l), compared to children with mild and moderate AD (median 1.66 μmol/l), but not to the control. Among inflammatory markers, only the group with severe AD demonstrated significantly elevated platelet count (PLT), red blood cell distribution width (RDW), and eosinophil count (EO). Retinol level correlated with PLT (R = −0.7; P = 0.003), white blood count (WBC) (R = −0.54; P = 0.01), total IgE (R = −0.51; P = 0.016), mean platelet volume (MPV) (R = 0.51; P = 0.02), and also with a disease severity index, SCORAD (R = −0.55; P = 0.007), whereas vitamin D level correlated only with MPV (R = 0.61; P = 0.003). No significant changes were found in tocopherol and CoQ10 levels between groups. Conclusions Children with AD should be routinely tested for vitamin D deficiency, especially during disease exacerbation. Our results confirmed correlation of serum inflammatory markers with decreased concentration of vitamin A in children with AD. This finding, however, might be an effect of severe stage of disease and not only of inadequate intake of retinol in the diet.

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Serum Vitamin D Levels Not Associated with Atopic Dermatitis Severity

Abstract: Levels of 25-hydroxyvitamin D were deficient or insufficient in 85% of the children, but serum vitamin D concentrations were not significantly related to AD severity.

Cited by 26 publications

References 18 publications

Vitamin D levels and susceptibility to asthma, elevated immunoglobulin E levels, and atopic dermatitis: A Mendelian randomization study

Vitamin D levels and susceptibility to asthma, elevated immunoglobulin E levels, and atopic dermatitis: A Mendelian randomization study

The association between atopic dermatitis and serum 25‐hydroxyvitamin D in children: Influence of sun exposure, diet, and atopy features—A cross‐sectional study

Association of antioxidants and vitamin D level with inflammation in children with atopic dermatitis

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