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Comparing Vitamin D Level Between Patients with Psoriasis and Healthy Individuals: A Systematic Review and Meta-Analysis.

  • 2023-01
  • Journal of evidence-based integrative medicine 28
    • Mahmood Moosazadeh
    • Giovanni Damiani
    • Mohammad Khademloo
    • Motahareh Kheradmand
    • Fatemeh Nabinezhad-Male
    • Amirhossein Hessami

Study Design

Type
Meta-Analysis
Sample size
n = 1,387
Population
1387 PsO cases and 6939 controls
Methods
Systematic review and meta-analysis; searched in PubMed, Scopus, Web of Sciences, ScienceDirect and SID using terms 'Vitamin D' and 'Psoriasis'; quality assessment using NOS; odds ratio and mean serum vitamin D levels calculated; heterogeneity assessed with I2 and Q; sensitivity analysis and publication bias considered

Background

Psoriasis is nowadays regarded as a systemic inflammatory disorder. Among the topicals, vitamin D derivates are often applied on the skin for their anti-inflammatory and immune-modulatory properties. Vitamin D serum levels in psoriasis (PsO) patients are still debated and an eventual depletion may offer the rational to integrate anti-psoriatic therapies with oral vitamin D. Then, we aimed to perform a systematic review and meta-analysis on the current evidence towards serum vitamin D level in PsO.

Methods

We searched in PubMed, Scopus, Web of Sciences, ScienceDirect and Science Information Database (SID) using the terms "Vitamin D" and "Psoriasis" including manuscripts in English, Italian and Persian. Duplications were excluded using EndNote software and records were screened by title, abstract and full-text. Quality assessment of studies was assessed using Newcastle Ottawa Checklist (NOS). Psoriasis odds ratio (OR) and mean serum vitamin D levels were calculated and displayed in Forest-plots. Heterogeneity indexes were evaluated using I2 and Q. Sensitivity analysis and publication biases were also considered.

Results

From 3006 records extracted, after removing duplicates and analyzing full texts we finally included 19 manuscripts involving a total of 1387 PsO cases and 6939 controls. PsO patients exhibited a substantial odds ratio (3.07, 95% CI: 1.56-6.04) for lower serum vitamin D levels compared to the control group. Standardized Mean Difference (SMD) of vitamin D in PsO versus controls was -0.92 (-1.33 to -0.51).

Conclusion

Psoriatic patients displayed higher risk to have a vitamin D deficiency. Interventional studies to verify the preventive value are mandatory.

Research Insights

  • Vitamin D→Reduced Vitamin D Level

    PsO patients exhibited a substantial odds ratio (3.07, 95% CI: 1.56-6.04) for lower serum vitamin D levels compared to the control group. Standardized Mean Difference (SMD) of vitamin D in PsO versus controls was -0.92 (-1.33 to -0.51).

    Effect
    Harmful
    Effect size
    Large
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