Relationship between Homocysteine,Vitamin B12, Folic acid Levels and Vitiligo

摘要

Background: Vitiligo is an acquired depigmenting disorder caused by destruction of melanocytes. The exact etiopathogenesis of vitiligo is unknown. An association between vitiligo and reduced serum levels of vitamin B12 and folic acid has been found, which are the important cofactors required in the metabolism of Homocysteine (Hcy).Consequently, Hcy level increases in the circulation. Hcy may mediate melanocyte destruction via increased oxidative damage, interleukin 6 production and nuclear factor κB (NFκB) activation.Objective: To evaluate serum homocysteine level, vitaminB12 and folic acid in patients with vitiligo. Patients and Methods: A total of 70 vitiligo patients of both sexes and 20 healthy controls were enrolled in this study. Sera from patients and controls were assayed for total Hcy ,vitamin B12 and folic acid .Results: The mean serum level of Hcy (15.2± 9.3 umol/L) was significantly higher in patients group than that in controls (8.4± 3.06μmol/L) (P=0.003). The Hcy level was significantly higher in male patients (19.14±9.3 umol/L) compared to (9.7±5.08 umol/L) in females. Hyperhomocysteinaemia, was detected in 21(30%)of 70 cases of vitiligo compared to 2(10%) in control group (p= 0. 0.001). The mean Hcy level was (24± 10.5 umol/L) significantly higher in active patient group than that in stable group (8.33± 3.4 μmol/L) (P=0.001). Mean value of serum folic acid (8.87± 2.9ng/ml Vs 9.87± 3.22ng/ml) and vitamin B12 ( 297.28±94.251pg/ml Vs323.8± 84.33pg/ml ) were not significantly decreased in vitiligo group as compared to controls.Serum Hcy associated positively with VASI score.Conclusion: An increased serum Hcy may be a precipitating factor for vitiligo in the predisposed individuals. Serum Hcy is related to the gender of patients, activity of disease.