Serum homocysteine, folate, and vitamin B12 levels in patients with vitiligo and their potential roles as disease activity biomarkers: A systematic review and meta-analysis

Publication date: March 2019

Source: Journal of the American Academy of Dermatology, Volume 80, Issue 3

Author(s): Tsung-Yu Tsai, Che-Yuan Kuo, Yu-Chen Huang

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.

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