Background

Antioxidant status is considered as important factor in the pathogenesis of vitiligo. However, there are controversial findings about serum status of antioxidants in vitiligo patients. The purpose of this study was to systematically review the evidences comparing the serum levels of antioxidant vitamins and minerals between vitiligo patients and controls, and performing meta-analysis of the results.

Methods

A comprehensive search was performed for studies comparing the serum status of antioxidant vitamins and minerals using following databases since inception up to 30 April 2020; PubMed, EMBASE, Scopus, and Web of Science. Data extraction was done by two independent reviewers. The data was pooled for serum level of each antioxidant comparing between vitiligo and control groups.

Results

Thirteen studies were included in this systematic review. The serum level of vitamin A, C, E, selenium, zinc and copper were compared between vitiligo patients and controls in these studies. Eleven studies including 570 vitiligo cases and 580 controls were included in the meta-analysis. Serum vitamin A and copper level in vitiligo patients were only evaluated in single studies and not included in meta-analysis. Based on fixed effect model, there were no statistical difference between two groups regarding serum vitamin C (OR = 1.17, 95 % CI, 0.74–1.84, P = 0.495), and vitamin E (OR = 0.61, 95 % CI, 0.30–1.25, P = 0.180). Higher serum zinc can decrease the risk of vitiligo based on sensitivity analysis of the results. (OR = 0.29, 95 % CI 0.15−0.54, P < 0.001). Higher serum selenium level significantly increased the risk of vitiligo (OR = 4.31, 95 % CI, 2.72–6.81, P < 0.001). Vitamin A was not significantly different in two reported groups (6.35 ± 1.53 vs 6.77 ± 1.46 μg/mL, P > 0.05). Copper was significantly higher in vitiligo patients compared to controls (129 ± 33 vs 99 ± 19 μg /100 mL, P = 0.002).

Conclusion

The current meta-analysis of data on serum level of most studied antioxidants (vitamin C, vitamin E, zinc and selenium) in patients suffering vitiligo showed that higher serum selenium (OR = 4.31) and lower zinc level (OR = 0.29) can increased the risk of vitiligo. Potential mechanism associated with preventive effects of zinc and the depigmentation effect of selenium should be more elucidated in further studies.

中文翻译：

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白癜风患者血清抗氧化维生素和矿物质水平的系统评价和荟萃分析。

背景

抗氧化状态被认为是白斑病发病的重要因素。然而，关于白癜风患者血清抗氧化剂状态的研究结果存在争议。本研究的目的是系统地回顾比较白癜风患者和对照组血清抗氧化维生素和矿物质水平的证据，并对结果进行荟萃分析。

方法

自成立至 2020 年 4 月 30 日，使用以下数据库对比较抗氧化维生素和矿物质的血清状态的研究进行了全面搜索；PubMed、EMBASE、Scopus 和科学网。数据提取由两名独立审查员完成。将数据汇总用于比较白斑组和对照组的每种抗氧化剂的血清水平。

结果

本系统评价纳入了 13 项研究。在这些研究中，比较了白癜风患者和对照组之间维生素 A、C、E、硒、锌和铜的血清水平。荟萃分析包括 11 项研究，包括 570 名白癜风病例和 580 名对照。白癜风患者的血清维生素 A 和铜水平仅在单项研究中进行评估，未纳入荟萃分析。基于固定效应模型，两组血清维生素C（OR = 1.17, 95 % CI, 0.74-1.84, P = 0.495）和维生素E（OR = 0.61, 95 % CI, 0.30- 1.25，P = 0.180）。根据结果​​的敏感性分析，较高的血清锌可以降低患白癜风的风险。（OR = 0.29，95% CI 0.15-0.54，P < 0.001）。较高的血清硒水平显着增加了白癜风的风险（OR = 4.31，95% CI，2.72–6.81，P < 0.001）。两个报告的组中维生素 A 没有显着差异（6.35 ± 1.53 vs 6.77 ± 1.46 μg/mL，P > 0.05）。与对照组相比，白癜风患者的铜含量显着更高（129 ± 33 vs 99 ± 19 μg/100 mL，P = 0.002）。

结论

目前对白癜风患者中大多数研究的抗氧化剂（维生素 C、维生素 E、锌和硒）的血清水平数据的荟萃分析表明，较高的血清硒 (OR = 4.31) 和较低的锌水平 (OR = 0.29) 可以增加白癜风的风险。与锌的预防作用和硒的脱色作用相关的潜在机制应在进一步的研究中进一步阐明。