The The role of high-dose vitamin D supplementation on disease severity and lipid profile in psoriatic patients
Abstract
Background/Aim: Psoriasis is a chronic inflammatory skin disease that is associated with a higher prevalence of cardiovascular (CV) risk factors. The effect of vitamin D on bone health has been long known, but its extraskeletal role especially in cardiovascular disease and skin disease, is the subject of recent research. This study aimed to assess the influence of high-dose vitamin D supplementation on the Psoriasis Area and Severity Index (PASI) score and lipid profile in patients with psoriasis.
Methods: The study included 20 adult patients with chronic plaque psoriasis. They received vitamin D capsules in a daily dose of 5,000 IU over 12 weeks. Measured serum concentrations of lipid metabolism parameters were triglycerides (TG), total cholesterol (TC), low-density lipoproteins (LDL) and high-density lipoproteins (HDL). PASI was used to determine the severity of the disease.
Results: High-doses vitamin D supplementation had a significant influence on reduction in PASI score in all patients (17.99 ± 12.42 vs 10.27 ± 8.53; p < 0.001). The supplementation of high dose vitamin D induced statistically significant lowering of the TC, LDL-C and TG in the psoriatic patients (p < 0.05). Furthermore, significant increase in serum HDL-C level was observed. The change of PASI score showed week positive correlation with the changes in serum TC and LDL-C (r = 0.303, p = 0.03 and r = 0.357 p = 0.013).
Conclusion: High-dose vitamin D supplementation had a positive impact on clinical status of the chronic plaque psoriasis patients, measured by PASI score. It also improved the serum lipid profile of these patients. Double-blinded prospective studies are needed in order to get more comprehensive data related to vitamin D, lipid metabolism and severity of psoriasis.
References
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28. Barrea L, Savanelli MC, Di Somma C, et al. Vitamin D and its role in psoriasis: An overview of the dermatologist and nutritionist. Rev Endocr Metab Disord 2017;18(2):195-205.
29. Mattozzi C, Paolino G, Richetta AG, Calvieri S. Psoriasis, Vitamin D and the importance of the cutaneous barrier’s integrity: An update. J Dermatol 2016;43(5):507-14.
30. Orgaz-Molina J, Buendía-Eisman A, Arrabal-Polo MA, Ruiz JC, Arias-Santiago S. Deficiency of serum concentration of 25-Hydroxyvitamin D in psoriatic patients: A case-Control study. J Am Acad Dermatol 2012;67(5):931-8.
31. Morimoto S, Yoshikawa K, Kozuka T, et al. An open study of vitamin D3 treatment in psoriasis vulgaris. Br J Dermatol 1986;115(4):421-429.
32. Finamor DC, Sinigaglia-Coimbra R, Neves LCM, Gutierrez M, Silva JJ, Torres LD, et al. A pilot study assessing the effect of prolonged administration of high daily doses of vitamin D on the clinical course of vitiligo and psoriasis. Dermatoendocrinol 2013;5(1):222-34.
33. Disphanurat W, Viarasilpa W, Chakkavittumrong P, Pongcharoen P. The Clinical Effect of Oral Vitamin D2 Supplementation on Psoriasis: A Double-Blind, Randomized, Placebo-Controlled Study. Dermatol Res Pract 2019;2019:11-13. doi:10.1155/2019/5237642
34. Jarrett P, Camargo CA, Coomarasamy C, Scragg R. A randomized, double-blind, placebo-controlled trial of the effect of monthly vitamin D supplementation in mild psoriasis. J Dermatolog Treat 2018;29(4):324-8.
35. Sunitha S, Rajappa M, Thappa DM, Chandrashekar L, Munisamy M, Revathy G. Is the ratio of antibodies against oxidized LDL to oxidized LDL an indicator of cardiovascular risk in psoriasis? Oman Med J 2016;31(5):390-3.
2. Lin X, Meng X, Song Z. Homocysteine and psoriasis. Biosci Rep 2019;39(11):1-15.
3. Hawkes JE, Chan TC, Krueger JG. Psoriasis pathogenesis and the development of novel targeted immune therapies. J Allergy Clin Immunol 2017;140(3):645-53.
4. Jindal S, Jindal N. Psoriasis and Cardiovascular Diseases: A Literature Review to Determine the Causal Relationship. Cureus 2018;10(2). doi:10.7759/cureus.2195
5. Boehncke WH. Systemic inflammation and cardiovascular comorbidity in psoriasis patients: Causes and consequences. Front Immunol 2018;9. doi:10.3389/fimmu.2018.00579.
6. Pietrzak A, Chabros P, Grywalska E, et al. Serum lipid metabolism in psoriasis and psoriatic arthritis – An update. Arch Med Sci 2019;15(2):369-75.
7. Nakhwa YC, Rashmi R, Basavaraj KH. Dyslipidemia in Psoriasis: A Case Controlled Study. Int Sch Res Not 2014;2014:1-5. doi:10.1155/2014/729157
8. Hilger J, Friedel A, Herr R, et al. A systematic review of vitamin D status in populations worldwide. Br J Nutr 2014;111(1):23-45.
9. Bergler Czop B, Brzezinska Wcisło L. Serum Vitamin D level - The effect on the clinical course of psoriasis. Postep Dermatolog Alergol 2016;33(6):445-9.
10. Hambly R, Kirby B. The relevance of serum vitamin D in psoriasis: a review. Arch Dermatol Res 2017;309(7):499-517.
11. Schmitt J, Wozel G. The psoriasis area and severity index is the adequate criterion to define severity in chronic plaque-type psoriasis. Dermatology 2005;210(3):194-9.
12. Batuca J, Lamy M, Neves M, Batista F, Pavia-Lopes MJ, Valverde AH et al. Anti-apolipoprotein A-I (ApoA-I) antibodies have different target epitopes in different clinical conditions. Atherosclerosis 2017;263:e216-7. doi:10-1016/j.atherosclerosis.2017.06.705
13. Soleymani T, Hung T, Soung J. The role of vitamin D in psoriasis: A review. Int J Dermatol 2015;54(4):383-92.
14. AlQuaiz AJM, Kazi A, Youssef RM, Alshehri N, Alduraywish SA. Association between standardized vitamin 25(OH)D and dyslipidemia: A community-based study in Riyadh, Saudi Arabia. Environ Health Prev Med 2020;25(1):4. doi:10.1186/s12199-019-0841-5
15. Sharif-Askari FS, Sharif-Askari NS, Halwani R, Abusnana S, Hamoudi R, Sulaiman N. Low vitamin D serum level is associated with HDL-C dyslipidemia and increased serum thrombomodulin levels of insulin-resistant individuals. Diabetes, Metab Syndr Obes Targets Ther 2020;13:1599-607.
16. Wang Y, Si S, Liu J, Wang Z, Jia H, Feng K, Sun L, Song SJ. The Associations of Serum Lipids with Vitamin D Status. PLoS One. 2016;21:11(10):e0165157. doi: 10.1371/journal.pone.0165157
17. Wang L, Song Y, Manson JE, Pilz S, März W, Michaelsson K et al. Circulating 25-Hydroxy-Vitamin D and risk of cardiovascular disease: A meta-analysis of prospective studies. Circ Cardiovasc Qual Outcomes 2012;5(6):819-29.
18. Bashir NA, Bashir AAM, Bashir HA. Effect of Vitamin D deficiency on Lipid Profile. Am J Lab Med 2019;4(1):11-8.
19. Tekin NS, Tekin IO, Barut F, Sipahi EY. Accumulation of oxidized low-density lipoprotein in psoriatic skin and changes of plasma lipid levels in psoriatic patients. Mediators Inflamm 2007;2007:78454. doi:10.1155/2007/78454
20. Azfar RS, Gelfand JM. Psoriasis and metabolic disease: epidemiology and pathophisiology. Curr Opin Rheumatol 2008;20(4):416-22.
21. Jones SM, Harris CPD, Lloyd J, Stirling CA, Reckless JPD, McHugh NJ. Lipoproteins and their subfractions in psoriatic arthritis: Identification of an atherogenic profile with active joint disease. Ann Rheum Dis 2000;59(11):904-9.
22. Orgaz-Molina J, Magro-Checa C, Rosales-Alexander JL, Arrabal-Polo MA, Buendia-Eisman A, Raya-Avarez E et al. Association of 25-hydroxyvitamin D serum levels and metabolic parameters in psoriatic patients with and without arthritis. J Am Acad Dermatol 2013;69(6):938-46.
23. Ramiro-Lozano JM, Calvo-Romero JM. Effects on lipid profile of supplementation with vitamin D in type 2 diabetic patients with vitamin D deficiency. Ther Adv Endocrinol Metab 2015;6(6):245-48.
24. Exebio JC, Ajabshir S, Campa A, Li T, Zarini GG, Huffman FG. The Effect of Vitamin D Supplementation on Blood Lipids in Minorities with Type 2 Diabetes. Int J Diabetes Clin Res 2018;5(3):1-7.
25. Ponda M, Dowd K, Finkielstein D, Holt PR, Breslow JL. The Short-Term Effects of Vitamin D Repletion on Cholesterol: A Randomized Placebo-Controlled Trial. Arter Thromb Vasc Biol 2012;32(10):2510-5.
26. Sadiya A, Ahmed SM, Carlsson M, et al. Vitamin D supplementation in obese type 2 diabetes subjects in Ajman, UAE: A randomized controlled double-blinded clinical trial. Eur J Clin Nutr 2015;69(6):707-11.
27. Kane L, Moore K, Lütjohann D, Bikle D, Schwartz JB. Vitamin D3 effects on lipids differ in statin and non-statin-treated humans: Superiority of free 25-OH D levels in detecting relationships. J Clin Endocrinol Metab 2013;98(11):4400-9.
28. Barrea L, Savanelli MC, Di Somma C, et al. Vitamin D and its role in psoriasis: An overview of the dermatologist and nutritionist. Rev Endocr Metab Disord 2017;18(2):195-205.
29. Mattozzi C, Paolino G, Richetta AG, Calvieri S. Psoriasis, Vitamin D and the importance of the cutaneous barrier’s integrity: An update. J Dermatol 2016;43(5):507-14.
30. Orgaz-Molina J, Buendía-Eisman A, Arrabal-Polo MA, Ruiz JC, Arias-Santiago S. Deficiency of serum concentration of 25-Hydroxyvitamin D in psoriatic patients: A case-Control study. J Am Acad Dermatol 2012;67(5):931-8.
31. Morimoto S, Yoshikawa K, Kozuka T, et al. An open study of vitamin D3 treatment in psoriasis vulgaris. Br J Dermatol 1986;115(4):421-429.
32. Finamor DC, Sinigaglia-Coimbra R, Neves LCM, Gutierrez M, Silva JJ, Torres LD, et al. A pilot study assessing the effect of prolonged administration of high daily doses of vitamin D on the clinical course of vitiligo and psoriasis. Dermatoendocrinol 2013;5(1):222-34.
33. Disphanurat W, Viarasilpa W, Chakkavittumrong P, Pongcharoen P. The Clinical Effect of Oral Vitamin D2 Supplementation on Psoriasis: A Double-Blind, Randomized, Placebo-Controlled Study. Dermatol Res Pract 2019;2019:11-13. doi:10.1155/2019/5237642
34. Jarrett P, Camargo CA, Coomarasamy C, Scragg R. A randomized, double-blind, placebo-controlled trial of the effect of monthly vitamin D supplementation in mild psoriasis. J Dermatolog Treat 2018;29(4):324-8.
35. Sunitha S, Rajappa M, Thappa DM, Chandrashekar L, Munisamy M, Revathy G. Is the ratio of antibodies against oxidized LDL to oxidized LDL an indicator of cardiovascular risk in psoriasis? Oman Med J 2016;31(5):390-3.
Published
2020/09/30
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