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Session: Micronutrients, Supplements and Chronic Disease Mechanisms (Poster Theater Flash Session 12)

(PTFS12-04-23) Association of Serum Vitamin D Levels and Psoriasis Severity: An Analysis of the US National Health and Nutrition Examination Survey

Tuesday, July 25, 2023
10:17 AM – 10:21 AM ET
Location:  Fairfax

    Presenting Author(s)

  • Rachel K. Lim, BA (she/her/hers)

    Medical Student
    Warren Alpert Medical School of Brown University
    Providence, Rhode Island, United States

    Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • SW

    Seungmin Woo, BA

    Warren Alpert Medical School of Brown University

  • SE

    Sherif El Raheb, BS

    Massachusetts College of Pharmacy and Health Sciences

  • AQ

    Abrar Qureshi, MD,MPH

    Warren Alpert Medical School of Brown University

  • Eunyoung Cho, ScD

    Associate Professor of Dermatology
    Warren Alpert Medical School of Brown University
    Providence, Rhode Island, United States

Disclosure(s):
Rachel K. Lim, BA: No relevant financial relationship(s) with ineligible companies to disclose.
Objectives: Vitamin D plays an important role in psoriasis pathogenesis in the modulation of immunity and effects on keratinocytes. However, few epidemiological studies on vitamin D status and psoriasis severity exist, especially in US populations. This study aimed to examine the associations between Vitamin D status and psoriasis severity, quantified as body surface area (BSA) affected by psoriasis, in a nationally representative sample of US adults.

Methods: Psoriasis cases were identified using the National Health and Nutrition Examination Survey (NHANES) between 2003-2006 and 2011-2014. Data on serum 25-hydroxyvitamin D [25(OH)D] levels, self-reported BSA, and covariates including age, gender, race, body mass index, and smoking status were extracted. Vitamin D deficiency was defined as serum 25(OH)D < 50 nmol/L. BSA was categorized into < 1 hand palm, 1-2 hand palms, 3-10 hand palms, and >10 hand palms affected. Multivariate linear regression was used to evaluate the association between vitamin D deficiency and psoriasis severity adjusting for the covariates. Trends were tested with a Wilcoxon-type test for trend. A p-value < 0.05 was considered statistically significant.

Results: 491 psoriasis cases were identified from the 40,401 participants screened, with 162 cases from 2003-2006 and 329 from 2011-2014. When evaluated by BSA categories, there was a linear trend of increasing severity of psoriasis by decreasing serum 25(OH)D levels; patients with the least BSA demonstrated the highest mean 25(OH)D levels (67 nmol/L) while those with the greatest BSA had the lowest mean 25(OH)D levels (56 nmol/L; p<sub>trend= 0.03). A similar trend was observed when percentage of vitamin D deficiency was evaluated by BSA, with 25% of patients in the lowest BSA category and 39% of patients in the highest BSA category being vitamin D deficient. A multivariate analysis supported similar findings: the association between vitamin D deficiency and BSA was significant (p=0.03).

Conclusions: In this large study based on a nationally representative sample of US population, we found that lower vitamin D levels and higher proportion of vitamin D deficiency was associated with increasing psoriasis severity, supporting the role of vitamin D in psoriasis pathogenesis and progression. 

Funding Sources: None