Vitamin D deficiency is associated with diagnosis and severity of childhood atopic dermatitis
Article first published online: 3 JAN 2014
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Pediatric Allergy and Immunology
Volume 25, Issue 1, pages 30–35, February 2014
How to Cite
Vitamin D deficiency is associated with diagnosis and severity of childhood atopic dermatitis. Pediatr Allergy Immunol 2014: 25: 30–35., , , , , .
- Issue published online: 19 FEB 2014
- Article first published online: 3 JAN 2014
- Manuscript Accepted: 7 OCT 2013
- Hong Kong Research Grants Council. Grant Number: 469908 and 470909
- Research Committee Group Research Scheme. Grant Number: 3110087
- Chinese University of Hong Kong. Grant Number: 2011.1.058
- atopic dermatitis;
- vitamin D
Recent studies implicated the importance of vitamin D in innate immune defense and pathogenesis of allergic diseases. However, the impact of vitamin D deficiency on atopic dermatitis (AD) diagnosis and severity remains unclear. This case–control study investigated such relationship in Hong Kong Chinese children.
Serum 25-hydroxyvitamin D [25(OH)D] levels of 498 AD children and 328 non-allergic controls were measured by immunoassay. Subjects were categorized into deficient (<25 nm), insufficient (25–49.9 nm), and sufficient (≥50 nm) groups. Short-term and long-term AD severity was evaluated by physician-diagnosed SCORing Atopic Dermatitis (SCORAD) and Nottingham Eczema Severity Score (NESS), respectively. Atopy biomarkers were also measured for analysis.
The mean (s.d.) serum 25(OH)D levels in AD patients and controls were 28.9 (15.3) and 34.2 (14.5) nm, respectively (p < 0.001). More patients had serum 25(OH)D levels <25 nm than controls (47.8% vs. 26.6%). AD severity as indicated by both SCORAD and NESS showed inverse associations with serum 25(OH)D levels (respective p = 3.6 × 10−4 and 0.004 when adjusted for age, sex, month of assessment, and immunoassay batch as covariates). Vitamin D-deficient patients (3.08 ± 0.76) had higher logarithm-transformed total IgE than those with insufficient (2.74 ± 0.69) and sufficient (2.72 ± 0.72) serum 25(OH)D levels (p < 0.001). The proportion of subjects with elevated IgE was higher in vitamin D-deficient (43.2%) than vitamin D-sufficient (20.0%) groups.
Vitamin D deficiency and insufficiency are prevalent in Hong Kong Chinese children. Vitamin D deficiency is associated with childhood AD and high total IgE. Serum 25(OH)D levels correlate inversely with both long- and short-term AD severity.