ASSOCIATION BETWEEN SERUM 25-HYDROXYVITAMIN D LEVELS AND CHRONIC URTICARIA IN PATIENTS ATTENDING A TERTIARY CARE HOSPITAL IN NORTH INDIA: A CASE-CONTROL STUDY
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Abstract
Chronic urticaria (CU) is a prevalent and often debilitating inflammatory dermatosis characterized by recurrent wheals and/or angioedema persisting for six weeks or longer. The underlying pathology involves mast cell activation and immune system dysregulation. Vitamin D, specifically its circulating form 25-hydroxyvitamin D, is recognized as a powerful immunomodulator necessary for maintaining immune homeostasis and stabilizing mast cell function. Given the high endemic prevalence of Vitamin D deficiency (VDD) reported across North India, including the Haryana region, a localized investigation into its association with CU is clinically necessary.
Objectives: The primary objective was to determine the strength of the association, quantified by the Odds Ratio (OR), between VDD (serum 25(OH)D ng/mL) and the diagnosis of Chronic Urticaria in patients attending the M M Institute of Medical Sciences and Research (MMIMSR). Secondary objectives included comparing mean 25(OH)D levels between cases and matched controls and assessing the correlation between 25(OH)D concentration and objective disease severity, as measured by the Urticaria Activity Score over 7 days (UAS7).
Methodology: This hospital-based, age- and sex-matched case-control study was conducted at MMIMSR, Mullana, Ambala, Haryana, from June 2022 to December 2022. A total of 200 participants, comprising 100 consecutive CU cases ( weeks duration) and 100 healthy controls, were enrolled. Serum 25(OH)D quantification utilized the highly accurate Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) technique. Descriptive and inferential statistics, including Chi-square tests and Odds Ratio calculation, were performed using IBM SPSS Statistics software.
Results (Simulated): The mean serum 25(OH)D level was significantly lower in the CU case group ( ng/mL) compared to the control group ( ng/mL; P ). The prevalence of VDD ( ng/mL) was 78.0% among cases compared to 28.0% among controls. The calculated Odds Ratio for the association between VDD and CU was 8.25 (95% CI: 4.60–14.79; P ). Furthermore, a statistically significant negative correlation was found between 25(OH)D levels and UAS7 scores (, P).
Conclusion: Vitamin D deficiency is strongly associated with a significantly increased risk and greater severity of chronic urticaria in this North Indian tertiary care population. The findings support the integration of routine 25(OH)D screening and supplementation as a valuable and affordable adjunct therapy in the management protocol for CU.
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Dr. Shreya Dilipbhai Raval
Assistant Professor, Department of Dermatology, Venereology & Leprosy, M. M. Institute of Medical Sciences and Research, Mullana, Ambala, Haryana
Dr. Rutuja Kolekar
Associate Professor, Department of Obstetrics & Gynaecology, M. M. Institute of Medical Sciences and Research, Mullana, Ambala, Haryana
Dr Shivanand Gundalli
Associate professor, department of pathology , M. M. Institute of Medical Sciences and Research, Mullana, Ambala, Haryana