Tsung-Yu Tsai1, Che-Yuan Kuo2, Yu-Chen Huang3. 1. Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. 2. Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan. 3. Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address: dhist2002@yahoo.com.tw.
Abstract
BACKGROUND: Hyperhomocysteinemia and folate and vitamin B12 deficiencies have been reported in patients with vitiligo. Investigating the role of these conditions might shed light on the pathogenesis of vitiligo. OBJECTIVE: To perform a systematic review and meta-analysis of studies assessing serum homocysteine, folate, and vitamin B12 levels in vitiligo patients. METHODS: Online databases were searched on May 15, 2018, to identify studies comparing serum homocysteine, folate, and vitamin B12 levels between patients with vitiligo and controls. A random effects model was used. RESULTS: Twenty-two studies involving a total of 1448 patients with vitiligo were included. Patients with vitiligo had significantly higher serum homocysteine levels (standardized mean difference [SMD] 0.550, 95% confidence interval [CI] 0.262-0.838; I2 87.3%) and lower vitamin B12 levels (SMD -0.430, 95% CI -0.738 to -0.121; I2 85.3%) than controls. Serum folate levels were not significantly different between the 2 groups (SMD -0.240, 95% CI -0.592 to 0.111; I2 85.5%). A subgroup analysis revealed that these findings correlated with disease activity. LIMITATIONS: The included studies were heterogeneous. Serum homocysteine levels could be influenced by various factors. CONCLUSION: Patients with vitiligo have higher serum homocysteine levels and lower vitamin B12 levels than individuals without vitiligo.
BACKGROUND:Hyperhomocysteinemia and folate and vitamin B12 deficiencies have been reported in patients with vitiligo. Investigating the role of these conditions might shed light on the pathogenesis of vitiligo. OBJECTIVE: To perform a systematic review and meta-analysis of studies assessing serum homocysteine, folate, and vitamin B12 levels in vitiligo patients. METHODS: Online databases were searched on May 15, 2018, to identify studies comparing serum homocysteine, folate, and vitamin B12 levels between patients with vitiligo and controls. A random effects model was used. RESULTS: Twenty-two studies involving a total of 1448 patients with vitiligo were included. Patients with vitiligo had significantly higher serum homocysteine levels (standardized mean difference [SMD] 0.550, 95% confidence interval [CI] 0.262-0.838; I2 87.3%) and lower vitamin B12 levels (SMD -0.430, 95% CI -0.738 to -0.121; I2 85.3%) than controls. Serum folate levels were not significantly different between the 2 groups (SMD -0.240, 95% CI -0.592 to 0.111; I2 85.5%). A subgroup analysis revealed that these findings correlated with disease activity. LIMITATIONS: The included studies were heterogeneous. Serum homocysteine levels could be influenced by various factors. CONCLUSION:Patients with vitiligo have higher serum homocysteine levels and lower vitamin B12 levels than individuals without vitiligo.