A review published in the American Scientific Journal found that patients with vitiligo have significantly lower serum levels of vitamin D, vitamin E and zinc compared to healthy people. Journal of the European Academy of Dermatology and Venereology.1
Furthermore, selenium and folate levels tend to be significantly elevated in vitiligo patients, whereas serum levels of vitamin B12 and copper show no detectable differences between individuals.
Background and methods
Researcher Iladji and his colleagues say that autoimmune and genetic factors have historically been thought to be important in the pathophysiology of vitiligo, so2 Researchers have previously investigated the relationship between pigmentation, oxidative stress, and serum levels of vitamins A, B, C, D, E, zinc, selenium, iron, and copper.3
Despite this existing research, the review authors argue that findings are inconclusive and controversial in nature. Therefore, they sought to gain a deeper understanding of the existing scientific literature on the role of vitamins and minerals in vitiligo.
The scoping review examined English and Persian language articles uploaded to PubMed, EMBASE, Scopus, Web of Science, Magiran, SID, and ISC up to December 2022. Key search terms included “vitiligo,” “depigmented lesions,” and the names of the respective vitamins and minerals.
Studies included in the review were observational and met the population-exposure-comparison-outcome criteria, but in vitro studies or studies involving animals were excluded from the review.
Investigation result
The initial search, including filtering studies from databases and identifying studies identified from citation searches, yielded a total of 281 studies. Of these, only 47 papers were included in the final review.
This review found significant differences in copper levels between vitiligo patients and healthy individuals, but heterogeneity was low. Sensitivity analyses showed that when one study was excluded, the difference in copper levels was no longer significant.
The researchers noted a large difference in vitamin E levels between vitiligo patients and healthy subjects, with patients having lower levels of vitamin E. Results were highly heterogeneous, indicating variability across studies.
Zinc concentrations in vitiligo patients were also significantly lower compared with healthy controls, with considerable heterogeneity.
For vitamin D, no significant differences were found between vitiligo patients and healthy individuals, despite high heterogeneity. Similarly, for selenium levels, no significant differences were initially found between vitiligo patients and healthy controls, despite high heterogeneity. However, sensitivity analyses showed that selenium levels were significantly higher in vitiligo patients after excluding one study.
Furthermore, folate levels were not significantly different between vitiligo patients and healthy controls, with low heterogeneity.Sensitivity analyses revealed that folate levels were significantly higher in vitiligo patients after excluding certain studies.
No significant differences were found in vitamin B12 levels between vitiligo patients and healthy subjects, with high heterogeneity.
Conclusion
The researchers concluded that the amount of evidence suggesting a role for vitamin C, vitamin A, and iron was insufficient to include in their analysis and called for additional, larger, population-based studies.
Limitations of this review include the limited number of studies resulting in limited data and a lack of generalizability, as well as the potential significance of disease status with regard to serum levels.
“Our meta-analysis did not find any significant differences in serum levels of vitamin B12 and copper. We concluded that vitiligo patients had lower serum concentrations of vitamin D, vitamin E, and zinc. Conversely, these patients had higher levels of selenium and folate compared to healthy individuals,” Iraji et al. wrote. “Overall, our results may be useful for deciding treatment strategies and whether to prescribe supplements.”
References
- Iraji F, Seyedyousefi S, Heidari A. Vitamins and trace elements in serum of patients with vitiligo: a systematic review and meta-analysis of observational studies. J Am Acad Dermatology Sexually Transmitted DiseasesApril 28, 2024 https://doi.org/10.1002/jvc2.432
- Alkhateeb A, Fain PR, Thody A, Bennett DC, Spritz RA. Epidemiology of vitiligo and related autoimmune diseases in Caucasian patients and their families. Pygeum cell research. 2003; 16(3):208–214. Original Article
- Huo J, Liu T, Huan Y, Li F, Wang R. Antioxidant vitamin and mineral concentrations in serum of patients with vitiligo: a systematic review and meta-analysis. J Trace Element Medical Biol.. 2020;62:126570.
