Vitamin D status in recurrent aphthous stomatitis

Abstract

IntroductionRecurrent aphthous stomatitis (RAS) is a common chronic inflammatory oral mucosa disease with an unknown cause. However, dysregulation of the immune response seems to play an important role in this disease.AimTo evaluate the vitamin D status in RAS patients and its effects on RAS severity, given the likely immunomodulatory function of vitamin D in the human organism.Material and methodsSixty-six patients with RAS and 66 controls were examined. Immunomodulatory or immunosuppressive treatment and other ulcerative oral diseases were used as exclusion criteria. The severity of RAS was assessed according to the clinical classification of the disease, the number of lesions per flare-up and the length of intervals between the attacks. The serum vitamin D level was established in each participant.ResultsThe mean serum vitamin D (25(OH)D) levels were found to be 16.81 ng/ml in the study group and 19.22 ng/ml in the control group, with no statistically significant difference between the two groups. In the study group, 5 (7.6%) participants were diagnosed with the “normal” vitamin D levels, while 16 (24.2%) had “insufficient” levels and 45 (68.2%) had “deficient” levels. The corresponding distribution in the control group was 8 (12.1%), 18 (27.3%) and 40 (60.6%), respectively. There was no statistical significance in the difference of vitamin D deficits between the study and the control groups. No correlation was detected between the severity of RAS and the serum vitamin D level.ConclusionsVitamin D does not seem to be a trigger factor for RAS occurrence and does not appear to influence the severity of the disease in the studied group.

Factors predispose to aphthous ulcer

“…And so, no correlation was detected between affection with aphthous ulcer and serum vitamin D level. 11 Iron level in our cases was normal in 14(35%) and low in 26(65%) compared to iron level in control group which is normal in 5(25%) and low in 15(75%). These results are against that made by Sumathi et al 2014, who made study on 50 cases and 25 controls and found iron level in the cases is normal in 17(34%) and low in 33(66%) compared to iron level in the control group which was normal in all of them.…”

“…10 In this study there were 17(42.5%) males and 23(57.5%) females in the case group, these results were close to the results of Krawiecka et al 2017 that was done on 66 cases 24 (36.4%) males and 42(63.6%) females. 11 We found that 30(75%) of cases have rounded ulcer compared to 10(25%) of cases have oval ulcer. Other study made by Akbar et al 2016 showed that round ulcer is more predominant than other shapes as 162(66%) of cases have rounded ulcers compared to 85(34%) of cases have other shapes of ulcer.…”

Vitamin D levels in patients with recurrent aphthous stomatitis

“…In consistent with this study, we found lower levels of serum 25-hydroxy vitamin D in patients with recurrent aphthous stomatitis compared to healthy individuals with similar age and gender distribution. Another study by Krawiecka et al [ 18 ], reported no significant difference between patients with recurrent aphthous stomatitis and healthy individuals in terms of serum vitamin D levels. Decreased vitamin D levels have been reported in various several disorders, including multiple sclerosis, infectious diseases, diabetes mellitus, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, thyroiditis and autoimmune gastritis [ 19 – 22 ].…”

Serum vitamin B12 associated with vitamin D/25(OH)D in women with recurrent aphthous stomatitis

“…25 However, another study reported that there was no difference of serum Vitamin D between RAS patients and healthy controls. 27 On the other hand, an intervention study showed that vitamin D supplementation had a beneficial effect in recurrent aphthous stomatitis. 26 Our study showed that all subjects have low/ This study revealed that serum vitamin B12 was associated with serum vitamin D/25(OH)D in RAS patients.…”

“…25,26 Another study revealed RAS patients tend to have low-level serum vitamin D compared with healthy control, but, there was not a significant difference in vitamin D status between both groups. 27 None of those studies showed that vitamin D status is associated with clinical parameters of RAS. Several studies have shown that vitamin D has an essential role in the immune response.…”