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

Thursday, Feb 01, 2018


Wang SS, Hon KL, Kong AP-s, Pong HN-h, Wong GW-k, Leung TF. Vitamin D deficiency is associated with diagnosis and severity of childhood atopic dermatitis. Pediatr Allergy Immunol. 2014 Feb; 25(1): 30–35. doi: 10.1111/pai.12167. Epub 2014 Jan 3. Link to PubMed

  • Background:
    The importance of vitamin D in inborn immune defense and pathogenesis of allergic diseases had been mentioned in recent studies. However, the impact of vitamin D deficiency on atopic dermatitis (AD) diagnosis and severity is yet to be clarified. This relationship was being investigated in this case-control study in Hong Kong Chinese children.
  • Method:
    • 826 unrelated Hong Kong Chinese children (498 AD cases and 328 non-allergic controls) were recruited. All controls did not report any AD, asthma and allergic rhinitis; all individuals were free from any respiratory infection for 4 weeks before study.
    • Serum 25-hydroxyvitamon D [25(OH)D] levels were measured by immunoassay, categorizing subjects into deficient (<25 nM), insufficient (25 – 49.9 nM), and sufficient (≥50 nM) groups.
    • Short-term and long-term AD severity was evaluated.
  • Key Findings:
    • The mean (s.d.) serum [25(OH)D] level in AD patients was 28.9 nM (15.3 nM) and that of controls was 34.2 nM (14.5 nM),  (p < 0.001).
    • More AD patients had a serum [25(OH)D] levels <25 nM (deficient, 47.8%) than controls (26.6%).
    • AD severity (indicated by both SCORAD and NESS)* showed to be inversely related to serum 25(OH)D levels (respective p = 3.6 x 10-4 and 0.004 when adjusted for age, sex, month of assessment, and immunoassay batch as covariates).
    • Vitamin D-deficient patients had higher logarithm-transformed total IgE^ (3.08 ± 0.76) than those with insufficient (2.74 ± 0.69) and sufficient (2.72 ± 0.72) serum 25(OH)D levels (p < 0.001).
    • Vitamin D-deficient patients had a higher percentage of individuals with elevated IgE (43.2%) than vitamin D-sufficient (20.0%) group.
  • Conclusion:
    Deficiency and insufficiency in vitamin D are common in Hong Kong Chinese children. Vitamin D deficiency is related to childhood AD and high total IgE. Serum [25(OH)D] level is inversely related to both long- and short-term AD severity.

*SCORAD: SCORing Atopic Dermatitis (measure short-term AD severity) ; NESS: Nottingham Eczema Severity Score (measure long-term AD severity)
^Logarithm-transformed total IgE: plasma total immunoglobulin E (IgE) concentration measured by microparticle immunoassay.



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