Association of Alopecia Areata with Vitamin D and Calcium Levels: A Systematic Review and Meta-analysis

Assessment of Intestinal Free Fatty Acid Binding Protein 4 in Alopecia Areata Patients

Introduction

Alopecia areata (AA) is an immune-mediated disease characterized by non-scaring hair loss. High levels of FABP4 have been implicated in different inflammatory diseases. We aim to assess and correlate the level of FABP4 in AA patients and compare with healthy controls.

Methods

Eighty-Eight subjects enrolled subdivided equally into AA and healthy controls. AA patients were classified according to the severity and pattern of the disease. The concentration level of FABP4 in serum was assessed and compared to healthy controls using ELISA.

Results

The level of FABP4 tends to increase in AA patients than controls with a significant difference (p = 0.0001).There were no statistically significant differences between FABP4 and gender, history, family history, related diseases, or prior treatments. There is a high significant difference between patients with relapse and progressive patients with p = 0.037. Also patients with positive effects in other body sites have higher FABP4 levels than patients without infection in other sites with p = 0.05. The level of FABP4 tends to increase with the severity of the patients. Findings show that there are positive correlations between FABP4 and (disease duration; number of attacks; SALT Score) with r = 0.45, p = 0.0021; r = 0.41, p = 0.007, and r = 0.88, p < 0.0001, respectively.

Conclusion

Elevation of FABP4 in serum may correlate with disease severity and could play a vital role in the diagnosis of AA.

Skin Disorders and Osteoporosis: Unraveling the Interplay Between Vitamin D, Microbiota, and Epigenetics Within the Skin-Bone Axis

Growing scientific evidence suggests a strong interconnection between inflammatory skin diseases and osteoporosis (OP), a systemic condition characterized by decreased bone density and structural fragility. These conditions seem to share common pathophysiological mechanisms, including immune dysregulation, chronic inflammation, and vitamin D deficiency, which play a crucial role in both skin and bone health. Additionally, the roles of gut microbiota (GM) and epigenetic regulation via microRNAs (miRNAs) emerge as key elements influencing the progression of both conditions. This review aims to examine the skin-bone axis, exploring how factors such as vitamin D, GM, and miRNAs interact in a subtle pathophysiological interplay driving skin inflammation and immune-metabolic bone alterations. Recent research suggests that combined therapeutic approaches-including vitamin D supplementation, targeted microbiota interventions, and miRNA-based therapies-could be promising strategies for managing comorbid inflammatory skin diseases and OP. This perspective highlights the need for multidisciplinary approaches in the clinical management of conditions related to the skin-bone axis.

The role of salivary vitamin D and interleukin-6 on non-scarring Alopecia

BACKGROUND

Alopecia, or hair loss, is an emerging global disease. Its etiopathogenesis includes nutritional deficiencies, oxidative stress, and deficiency of physiological factors. Around 2% of the general population has the probability of developing alopecia at any one period. Vitamin D and interleukin-6 (IL-6) have a major role in alopecia. The present goal of research is to investigate the role of vitamin D and IL-6 in the saliva of patients with non-scarring alopecia.

METHODOLOGY

The study involved 51 cases of non-scarring alopecia and 50 healthy controls with an age range between 18 and 40 years. A detailed history and clinical examination were done. Salivary vitamin D and IL-6 were determined to compare within the groups.

RESULTS

The average vitamin D level in cases (104.64 ± 46.95 pmol/L) was significantly lower as compared to controls (223 ± 12.03 pmol/L) (p < 0.001). Whereas the average amount of IL-6 was significantly higher (170.54 ± 63.68 ng/L) than the control group (56.38 ± 46.52 ng/L) (p < 0.001). No correlation of vitamin D level with IL-6 was detected in study subjects.

CONCLUSION

Vitamin D significantly influences the development of non-scarring alopecia. Patients with non-scarring alopecia had low amount of vitamin D indicate its role in etiology of hair loss. IL-6 may cause a collapse of the hair bulb, having a significant part in the pathogenesis of alopecia indicating chronic inflammatory or autoimmune condition. This research will aid in diagnosing scalp disease using salivary biomarkers and improve the treatment of alopecia.

Vitamin D deficiency in non-scarring and scarring alopecias: a systematic review and meta-analysis

Background

Numerous studies have linked vitamin D deficiency (VDD) to the pathogenesis of various alopecia disorders.

Objective

This study aimed to investigate whether patients with alopecia are more likely to have VDD or lower vitamin D levels than controls, and the prevalence of VDD among patients with certain alopecia disorders.

Methods

Electronic searches were conducted using PubMed, Embase, Scopus, and Cochrane Library databases from the dates of their inception until September 2024. Studies that reported data allowing for the calculation of odds ratios, mean differences, or correlation coefficients related to vitamin D levels and alopecia were included, while studies without a confirmed diagnosis of alopecia or those involving patients taking vitamin D supplements were excluded.

Results

It was found that 51.94% of patients with alopecia areata (AA), 50.38% of patients with female pattern hair loss (FPHL), 47.38% of patients with male androgenic alopecia (MAGA), 53.51% of patients with telogen effluvium (TE), and 38.85% of patients with primary scarring alopecia had VDD. Compared to controls, AA patients had a pooled odds ratio (OR) of VDD of 2.84 (95% confidence interval: 1.89-4.26, I2 = 84.29%, p < 0.01) and a pooled unstandardized mean difference (UMD) of vitamin D levels of -8.20 (-10.28 - -6.12, I2 = 74.25%, p < 0.01) ng/mL. For FPHL patients, a pooled OR of VDD of 5.24 (1.50-18.33, I2 = 81.65%, p < 0.01) and a pooled UMD of vitamin D levels of -15.67 (-24.55 - -6.79, I2 = 91.60%, p < 0.01) ng/mL were found. However, for MAGA, a pooled VDD OR of 4.42 (0.53-36.61, I2 = 88.40%, p < 0.01), and a pooled UMD of vitamin D levels of -2.19 ng/mL (-4.07 - -0.31 ng/mL, I2 = 7.64%, p = 0.37) were found. For TE patients, pooled UMD of vitamin D levels of -5.71 (-10.10 - -1.32) ng/mL were found.

Conclusion

People with alopecia frequently have VDD; however, only in patients with AA or FPHL was the association of VDD and decreased vitamin D levels statistically significant compared to control. The findings indicate screening for vitamin D could benefit patients with AA or FPHL, potentially addressing vitamin D deficiency. Further study on vitamin D supplementation as a treatment for alopecia is recommended.

Alopecia areata: What's new in the epidemiology, comorbidities, and pathogenesis?

BACKGROUND

Alopecia areata (AA) is a common, acquired, and nonscarring type of hair loss that affects people of every generation and is intractable in severe and relapsing cases. Patients with AA, especially those with greater scalp involvement, have poor health-related quality-of-life scores.

PURPOSE

Following our previous review article in the April 2017 issue of the Journal of Dermatological Science, we aim to provide a pair of review articles on recent progress in multidisciplinary approaches to AA.

MAIN FINDINGS

We found more than 1800 publications on AA from July 2016 to December 2022.

CONCLUSIONS

In this review, we focused on the latest information on the epidemiology, comorbidities, and pathogenesis of AA.

Vitamin D supplementation for patients with alopecia areata: A protocol for systematic review and meta-analysis

BACKGROUND

Several studies have reported an association between low Vitamin D (VD) levels and Alopecia areata (AA), and suggested VD preparations as a potential therapy. VD has immunomodulatory function closely associated with a variety of skin diseases, but there is no conclusive evidence to support VD supplementation for patients with AA. Therefore, we will conduct a meta-analysis to collect and evaluate the efficacy and safety of VD supplementation in the treatment of AA.

METHODS

We will search the following databases according to the developed strategy: Cochrane Library, PubMed, Web of Science, EMBASE, Scopus, Google scholar for Randomized controlled trials related to VD supplementation for AA. The retrieval time is from the establishment of each database to July 2022. Two reviewers will independently complete the literature search and screening, risk of bias assessment and data extraction. Severity of Alopecia Tool, Alopecia Density and Extent, Lesional area and senstivity (score) will be the primary results. RevMan V.5.3 will be used for data analysis and synthesis. For dichotomous outcomes and the continuous outcomes, we will calculate risk ratio with 95% Confidence intervals and mean differences or standardized mean differences with 95% Confidence intervals respectively. The reporting bias will be investigated using funnel plots, and the asymmetry of the funnel plots will be explained using the Harbord modified test or the Egger's regression test.

RESULTS

The results of the study expect to provide a high-quality, evidence-based recommendation on VD supplementation in the treatment of AA for clinicians.

CONCLUSIONS

The study will provide scientific and useful evidence for better use of VD supplementation in treating AA.

Role of vitamin D in hair loss: A short review

BACKGROUND

Vitamin D, a vitamin and hormone, plays an important role in dermatology and dermatotherapeutics, due to its anti-inflammatory and immunomodulatory properties, and regulation of keratinocyte differentiation and proliferation. It also affects the hair cycle, and its role in hair loss is under constant research.

OBJECTIVES

This review aims to give a brief overview of vitamin D biology within the hair follicle, role in the etiopathogenesis, and rationale for supplementation in various alopecias.

METHODS

A PubMed literature search was performed to review relevant current literature and studies investigating the role of vitamin D in the etiopathogenesis, as a supplement and a potential therapeutic modality in hair loss.

RESULTS AND CONCLUSION

Vitamin D is intricately involved in various signaling pathways of growth and differentiation of hair follicles. Most studies show an inverse relationship between serum vitamin D levels and non-scarring alopecias such as telogen effluvium, androgenetic alopecia, alopecia areata, and trichotillomania. Vitamin D deficiency is also associated with scarring alopecia. However, conclusive studies to demonstrate the benefit of vitamin D administration in correcting hair loss and managing these conditions are lacking. Hence, further studies are needed before vitamin D can be routinely recommended as a treatment modality in these conditions.