Vitamin D status in patients with chronic plaque psoriasis

Background Vitamin D could have important immunomodulatory effects in psoriasis. Objectives To measure 25-hydroxyvitamin D [25(OH) D], parathyroid hormone (PTH) and calcium serum levels in patients with psoriasis and the associations with some relevant clinical features. Methods A cross-sectional study was conducted over 1 year including 145 patients with chronic plaque psoriasis, 112 patients with rheumatoid arthritis (RA) and 141 healthy controls. 25(OH) D, PTH and calcium serum levels were measured in a centralized laboratory. Demography, comorbidities, disease severity and exposure time to sunlight (which was derived by questionnaire) were collected. Results The prevalence of vitamin D deficiency [25(OH) D levels < 20 ng mL(-1)] in patients with psoriasis was 57.8% vs. 37.5% in patients with RA and 29.7% in healthy controls (P < 0.001). In winter, the prevalence of vitamin D deficiency rose to 80.9% in patients with psoriasis, to 41.3% in those with RA and to 30.3% in healthy controls (P < 0.001). Patients with psoriasis or psoriatic arthritis did not differ in 25(OH) D serum levels nor in the prevalence of vitamin D deficiency. In the logistic regression analysis, vitamin D deficiency was associated with psoriasis independently of age, sex, body mass index, calcium, PTH levels and season of blood sampling. A limitation is that the study design does not allow a causal or temporal relationship between vitamin D deficiency and psoriasis to be established. Conclusions Vitamin D deficiency may be common in patients with psoriasis, especially in winter.