Evidence of a Causal Relationship Between Vitamin D Status and Risk of Psoriasis From the UK Biobank Study

Zhang, Yan; Jing, Danrong; Zhou, Guowei; Xiao, Yi; Shen, Minxue; Chen, Xiang; Liu, Hong

doi:10.3389/fnut.2022.807344

Cited by 12 publications

(7 citation statements)

References 36 publications

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“…A recent US study suggested a preventive effect of vitD supplements on autoimmune disease risk . Moreover, a recent mendelian randomization study found evidence of a causal relationship between genetically predicted lower 25(OH)D levels and incident psoriasis . Therefore, vitD may contribute to prevention and treatment of psoriasis.…”

Section: Discussionmentioning

confidence: 99%

Effect of Vitamin D Supplementation on Psoriasis Severity in Patients With Lower-Range Serum 25-Hydroxyvitamin D Levels

et al. 2023

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ImportanceTopical vitamin D analogues are routine treatment for psoriasis, but the effect of oral supplementation has not been established.ObjectiveTo examine the effect of vitamin D supplementation on psoriasis severity throughout the winter.Design, Setting, and ParticipantsThis randomized, double-blind placebo-controlled clinical trial with 2 parallel groups was performed through 2 winter seasons (2017 to 2018 and 2018 to 2019). Randomization was computer generated. All participants, health care clinicians, and outcome assessors were masked to group assignment. Each participant was followed for 4 months. The presented analyses were conducted in May 2022. The trial was conducted at the clinical research unit of the University Hospital of North Norway (Tromsø; Norway). Adults from the general population in Tromsø with active plaque psoriasis and 25-hydroxyvitamin D (25[OH]D) levels of less than 24 ng/mL (to convert to nmol/L, multiply by 2.496) were included.InterventionVitamin D (cholecalciferol, 100 000 IU, loading dose, followed by 20 000 IU/week) or placebo for 4 months.Main outcomes and MeasuresPsoriasis Area Severity Index (PASI) (primary outcome), Physician Global Assessment, self-administered PASI, and Dermatology Life Quality Index scores (secondary outcomes).ResultsA total of 122 participants (46 women [37.7%]; mean [SD] age, 53.6 [10.0] years; mean [SD] PASI score, 3.1 [2.0]; mean [SD] serum 25(OH)D, 14.9 [3.9] ng/mL) were included. Of these, 60 (49.2%) were randomized to the vitamin D group and 62 (50.8%) to the placebo group. A total of 120 participants (59 vitamin D [49.2%]/61 placebo [51.8%]) completed the study. By completion, mean (SD) 25(OH)D levels were 29.7 (5.2) ng/mL (vitamin D) and 12.0 (3.8) ng/mL (placebo). There was no significant difference in change in PASI score between the groups (adjusted difference, 0.11; 95% CI, −0.23 to 0.45). There was no significant difference in change in Physician Global Assessment score (adjusted odds ratio, 0.66; 95% CI, 0.27-1.63), self-administered PASI (adjusted difference, −0.60; 95% CI, −1.76 to 0.55) or Dermatology Life Quality Index (adjusted difference, −0.86; 95% CI, −1.9 to 0.19) between the groups. No adverse effects of the intervention were registered.Conclusion and RelevanceThe results of this randomized clinical trial showed that vitamin D supplementation did not affect psoriasis severity. Low baseline severity scores may explain the lack of measurable effect. Levels of 25(OH)D in the intervention group increased to a less-than-expected degree based on previous experimental data from the same source population, and this may have affected the results.Trial RegistrationClinicalTrials.gov Identifier: NCT03334136

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Section: Discussionmentioning

confidence: 99%

Effect of Vitamin D Supplementation on Psoriasis Severity in Patients With Lower-Range Serum 25-Hydroxyvitamin D Levels

et al. 2023

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“…Administrating vitamin D supplementation led to reduced mortality in patients with psoriasis [17] and topical vitamin D analogues demonstrated effectiveness in treating psoriasis [9]. A recent prospective study suggested that low 25(OH)D level was associated with high risk of psoriasis using both cox proportional hazard model and MR analysis [27]. It used 69 genetic variants that were identified in a GWAS meta-analysis of 443,734 European individuals as IVs in the MR analysis [45].…”

Section: Discussionmentioning

confidence: 99%

“…Recent genome-wide association studies (GWASs) have identified tens of thousands of genetic variants robustly associated with human complex diseases and traits [24], which as a result provide a wealth of potential IVs and facilitate MR analysis. MR analyses have investigated the causal effects of circulating 25(OH)D levels on the risk of psoriasis, atopic dermatitis, and vitiligo, suggesting that blood 25(OH)D levels confer a significant causal effect on psoriasis but not on atopic dermatitis or vitiligo [25][26][27]. Alternatively, MR suggests that genetically predicted risk of atopic dermatitis increases blood 25(OH)D level [28].…”

Section: Introductionmentioning

confidence: 99%

Causal Associations between Vitamin D Levels and Psoriasis, Atopic Dermatitis, and Vitiligo: A Bidirectional Two-Sample Mendelian Randomization Analysis

Ren

Liu

et al. 2022

Nutrients

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Background: Vitamin D level has been reported to be associated with psoriasis, atopic dermatitis, and vitiligo. However, its causal relationship with the risk of these three diseases remains unclear. Methods: We obtained genome-wide association statistics for three measures of circulating vitamin D levels (25(OH)D in 120,618 individuals, and 25(OH)D3 and epimeric form C3-epi-25(OH)D3 in 40,562 individuals) and for the diseases psoriasis (3871 cases and 333,288 controls), atopic dermatitis (21,399 cases and 95,464 controls), and vitiligo (4680 cases and 39,586 controls). We performed Mendelian randomization using inverse-variance weighted, weighted median, MR-Egger, and MR-pleiotropy residual sum and outlier methods. We carried out sensitivity analyses to evaluate the robustness of the results. Results: We showed that elevated vitamin D levels protected individuals from developing psoriasis (OR = 0.995, p = 8.84 × 10−4 for 25(OH)D; OR = 0.997, p = 1.81 × 10−3 for 25(OH)D3; and OR = 0.998, p = 0.044 for C3-epi-25(OH)D3). Genetically predicted risk of atopic dermatitis increased the levels of 25(OH)D (OR = 1.040, p = 7.14 × 10−4) and 25(OH)D3 (OR = 1.208, p = 0.048). A sensitivity analysis suggested the robustness of these causal associations. Conclusions: This study reported causal relationships between circulating vitamin D levels and the risk of psoriasis, atopic dermatitis, and vitiligo. These findings provide potential disease intervention and monitoring targets.

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“…Observational studies has found an association between lower serum 25-hydroxyvitamin D (25[OH]D) and psoriasis 13 . MR studies have additionally demonstrated a causal relationship from lower 25(OH)D to an increased risk of psoriasis 14,15 . Moreover, no reverse causal link has been observed 16 .…”

Section: Introductionmentioning

confidence: 99%

“…Recent observational studies suggest that the association between 25(OH)D and psoriasis may be modified by adiposity (BMI and hip-waist ratio) 14,17,18 . No previous studies have explored this possible combined effect (i.e.…”

Section: Introductionmentioning

confidence: 99%

Exploring interaction between genetically predicted body mass index and serum 25-hydroxyvitamin D levels on the odds for psoriasis in UK Biobank and the HUNT Study: A factorial Mendelian randomisation study

Jenssen,

Arora,

Løset

et al. 2024

Preprint

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Background: Mendelian randomisation (MR) studies show that higher body mass index (BMI) and lower 25-hydroxyvitamin D (25[OH]D) increase psoriasis risk. The combined effect of these factors has not been explored using factorial MR. Methods: Using cross-sectional data from UK Biobank (UKB, n=398 404) and the Troendelag Health Study (HUNT, n=86 648), we calculated polygenic risk scores for BMI and 25(OH)D to estimate odds ratios for psoriasis using 2x2 and continuous factorial MR. We quantified additive interaction by relative excess risk due to interaction (RERI)-estimates. We also performed traditional observational analyses in UKB. Results: There were 12 207 (3.1%) participants with psoriasis in UKB and 7794 (9.0%) in HUNT. In 2x2 factorial MR, we found no evidence of relative excess risk for psoriasis due to interaction between genetically predicted higher BMI and lower 25(OH)D, neither in UKB (RERI -0.01, 95% confidence interval (CI) -0.08, 0.07) nor in HUNT (RERI -0.04, 95% CI -0.14, 0.06). The same was observed in the continuous factorial MR and observational analyses. Conclusions: This study did not find evidence of interaction between BMI and 25(OH)D on the risk of psoriasis. Given minor differences in measured BMI and 25(OH)D between groups, small effects may have been undetected.

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Evidence of a Causal Relationship Between Vitamin D Status and Risk of Psoriasis From the UK Biobank Study

Cited by 12 publications

References 36 publications

Effect of Vitamin D Supplementation on Psoriasis Severity in Patients With Lower-Range Serum 25-Hydroxyvitamin D Levels

Effect of Vitamin D Supplementation on Psoriasis Severity in Patients With Lower-Range Serum 25-Hydroxyvitamin D Levels

Causal Associations between Vitamin D Levels and Psoriasis, Atopic Dermatitis, and Vitiligo: A Bidirectional Two-Sample Mendelian Randomization Analysis

Exploring interaction between genetically predicted body mass index and serum 25-hydroxyvitamin D levels on the odds for psoriasis in UK Biobank and the HUNT Study: A factorial Mendelian randomisation study

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