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Vitamin D deficiency is associated with diagnosis and severity of childhood atopic dermatitis

Authors

  • Susan Shuxin Wang,

    1. Department of Pediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
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  • Kam Lun Hon,

    1. Department of Pediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
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  • Alice Pik-shan Kong,

    1. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
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  • Henry Nga-hin Pong,

    1. Department of Pediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
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  • Gary Wing-kin Wong,

    1. Department of Pediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
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  • Ting Fan Leung

    Corresponding author
    1. Department of Pediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
    • Correspondence

      Ting Fan Leung, Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, 6/F, Lui Che Woo Clinical Sciences Building, Prince of Wales Hospital, Shatin, NT, Hong Kong.

      Tel.: (852) 2632 2981

      Fax: (852) 2636 0020

      E-mail: tfleung@cuhk.edu.hk

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

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