Association Between Serum Vitamin D Levels and Severity of Chronic Plaque Psoriasis: A Hospital-Based Observational Study
DOI:
https://doi.org/10.48047/34ja7k25Keywords:
psoriasis; vitamin D; 25-hydroxyvitamin D; PASI; disease severity; South IndiaAbstract
Background: Psoriasis is a chronic, immune-mediated inflammatory skin disease in which vitamin D signalling regulates keratinocyte proliferation and T-cell-driven inflammation. Whether circulating 25-hydroxyvitamin D [25(OH)D] is associated with disease severity remains debated, and data from South Indian populations—who experience widespread hypovitaminosis D despite abundant sunlight—are limited. Objectives: To assess the association between serum 25(OH)D levels and the severity of chronic plaque psoriasis among patients attending a tertiary care hospital in South India. Methods: A hospital-based observational comparative study was conducted in 180 patients with chronic plaque psoriasis. Severity was assessed using the Psoriasis Area and Severity Index (PASI) and patients were grouped as mild, moderate or severe. Serum 25(OH)D was measured and categorised as deficient, insufficient or sufficient. Quality of life was recorded with the Dermatology Life Quality Index (DLQI). Associations were examined using one-way ANOVA, the chi-square test and Pearson/Spearman correlation, with p<0.05 considered significant. Results: The mean age was 36.9 (SD 11.5) years and 58.3% were male. Mean PASI was 11.9 (SD 6.7) and mean serum 25(OH)D was 24.3 (SD 9.8) ng/mL; 36.7% of patients were vitamin D deficient and a further 33.3% insufficient. Mean 25(OH)D declined progressively across severity groups—mild 31.1, moderate 21.4 and severe 12.4 ng/mL (ANOVA F=63.3, p<0.001)—and PASI rose stepwise across vitamin D status categories (sufficient 6.4, insufficient 10.6, deficient 17.6; p<0.001). Serum 25(OH)D was strongly and inversely correlated with PASI (r=−0.74, p<0.001), body surface area (r=−0.64, p<0.001) and DLQI (r=−0.54, p<0.001). Vitamin D status and severity group were significantly associated (χ²=64.2, p<0.001). Conclusions: Lower serum vitamin D was strongly and independently associated with greater psoriasis severity and poorer quality of life in this South Indian cohort. While the cross-sectional design precludes causal inference, the findings support assessment of vitamin D status in psoriasis and warrant interventional study of supplementation.
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