Vitamin D deficiency and associated clinical co-factors in patients with early and late-onset plaque psoriasis
Keywords:
Psoriasis, body mass index, psoriatic arthritis, 25-hydroxy vitamin D, Psoriasis Area and Severity IndexAbstract
ABSTRACTBackground: Plaque psoriasis is associated with many metabolic disorders including vitamin D deficiency (VDD) but knowledge about VDD associated clinical cofactors in plaque psoriasis is lacking in Pakistani population.Objectives: To investigate 25-hydroxyvitamin D (25-OHVD) levels; to perform a comparative analysis between early and late-onset types of plaque psoriasis; and to identify any relationship between 25-OHVD levels and type of plaque psoriasis after controlling for confounders Methods: This cross-sectional, prospective study had 70 subjects and conducted in the Dermatology department during September 2018 to August 2019. Demographics and disease-related features were noted down; body mass index (BMI) and Psoriasis Area and Severity Index (PASI) were calculated; and serum levels of 25-OHVD were checked.Results: Mean+SD age was 41.3+13.2 years with equal gender ratio. Family history was positive in 19 (27.1%); presence of psoriatic arthritis (PsA) in 36 (51.4%); use of oral steroids in 14 (20%); while 40 (57.1%) patients had disease for ≤ 5 years. 42 (60%) and 28 (40%) patients belonged to early-onset and late-onset groups respectively. 35 (50%) patients were obese and median PASI score was 4.45. Mean 25-OHVD levels were 17.1+9.1 ng/mL. Comparative analysis revealed statistically significant differences between 25-OHVD levels (P=0.03), age (P<0.001), duration of psoriasis (P=0.01), use of oral steroids (P=0.01) and family history of psoriasis (P=0.04) of the two psoriatic groups. Stratified analysis disclosed males (P=0.003) who had disease for < 5 years (P=0.01) suffered from PsA (P=0.03) were more affected with VDD in early-onset group.Limitations: Small sample size, single-center studyConclusion: VDD is more frequent among early-onset plaque psoriasis cases. Cofactors associated with VDD are early age of presentation, lesser duration of disease, use of oral steroids and positive family history. Stratified analysis detected males of early-onset with disease duration of < 5 years and having PsA were more often affected with vitamin D deficiency.References
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