Priya Jeevamani, C (2015) 25-Hydroxyvitamin D Status of Patients with Psoriasis Vulgaris in a Tertiary Care Centre in South India: A Pilot study. Masters thesis, Christian Medical College, Vellore.
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Abstract
BACKGROUND: Psoriasis is now recognised as a systemic disease centered on inflammation and involvement of cytokines of the Th1 pathway. There are recent studies showing higher prevalence of vitamin D deficiency in patients with psoriasis than in control groups. (10–13) The discovery of the systemic role of vitamin D in the modulation of the immune system especially the Type 1 helper T cell (Th1) pathway suggests that low levels of vitamin D may have important implications in the pathogenesis of psoriasis. OBJECTIVES: Our primary objective was to determine the 25-hydroxyvitamin D status of patients with chronic plaque psoriasis in comparison with age and sex matched controls as a pilot study. Our secondary objective was to correlate the psoriasis disease characteristics with vitamin D level. METHODS: Forty-five consecutive consenting patients with chronic plaque psoriasis and 45 age and sex matched controls with minor dermatological diseases from Tamil Nadu were recruited in this study. Data on demographic profile, sun-exposure, sunscreen usage, smoking, alcohol, type of clothing, waist circumference, vitamin D level, fasting and post prandial sugars, total cholesterol, triglycerides, LDL and HDL were collected from all study participants. From the patients with psoriasis, data on duration of disease, disease severity as assessed by BSA and PASI, presence of arthritis / nail changes were also collected. RESULTS: The overall prevalence of vitamin D deficiency (≤ 20ng/ml) in the study subjects was 53.33%. Sixty two per cent cases and 44% controls had vitamin D deficiency with the observed difference not being statistically significant (p value = 0.096). The mean serum vitamin D levelwas similar among the cases and controls, 21.54 ± 9.41ng/ml and 21.24 ± 10.97 respectively (p =0.64). There was no statistically significant difference ( p = 0.15) in the mean vitamin D level between patients with type 1 psoriasis (19.56 ±9.8 ng/ml) and type 2 psoriasis (25.86 ± 12.99ng/ml). The mean serum vitamin D level was significantly (p = 0.0001) lower in patients who wore covered type of clothing (14.48 ± 6 ng/ml) when compared to those who wore clothing that allowed more photo-exposure (23.23 ± 10.28 ng/dl). With an increase in disease duration, there was a tendency towards decrease in vitamin D level (r = -0.2978, p = 0.047). There was no correlation between vitamin D level and psoriasis disease severity measures like PASI and BSA involvement, presence of arthritis and nail changes. The BMI (r = -0.300, p = 0.045) and fasting blood sugar (r = -0.319, p = 0.037) showed a negative correlation and the HDL level (r = 0.34, p = 0.026) showed a positive correlation with vitamin D level. Logistic regression analysis did not show any significant changes in vitamin D level attributable to the presence of psoriasis after adjusting for clothing, skin type, locality, occupation, sun exposure and BMI. In addition, the pattern of clothing was observed to be strongly associated with changes in vitamin D level after adjusting for confounders.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Vitamin D ; psoriasis ; metabolic syndrome. |
| Subjects: | MEDICAL > Dermatology Venereology and Leprosy |
| Depositing User: | Punitha K |
| Date Deposited: | 05 May 2018 09:58 |
| Last Modified: | 05 May 2018 09:58 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7492 |
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