Vitamin D deficiency is associated with diagnosis and severity of childhood atopic dermatitis

Pediatr Allergy Immunol. 2014 Feb;25(1):30-5. doi: 10.1111/pai.12167. Epub 2014 Jan 3.


Background: Recent studies implicated the importance of vitamin D in innate immune defense and pathogenesis of allergic diseases. However, the impact of vitamin D deficiency on atopic dermatitis (AD) diagnosis and severity remains unclear. This case-control study investigated such relationship in Hong Kong Chinese children.

Methods: Serum 25-hydroxyvitamin D [25(OH)D] levels of 498 AD children and 328 non-allergic controls were measured by immunoassay. Subjects were categorized into deficient (< 25 nm), insufficient (25-49.9 nm), and sufficient (≥ 50 nm) groups. Short-term and long-term AD severity was evaluated by physician-diagnosed SCORing Atopic Dermatitis (SCORAD) and Nottingham Eczema Severity Score (NESS), respectively. Atopy biomarkers were also measured for analysis.

Results: The mean (s.d.) serum 25(OH)D levels in AD patients and controls were 28.9 (15.3) and 34.2 (14.5) nm, respectively (p < 0.001). More patients had serum 25(OH)D levels <25 nm than controls (47.8% vs. 26.6%). AD severity as indicated by both SCORAD and NESS showed inverse associations with serum 25(OH)D levels (respective p = 3.6 × 10(-4) and 0.004 when adjusted for age, sex, month of assessment, and immunoassay batch as covariates). Vitamin D-deficient patients (3.08 ± 0.76) had higher logarithm-transformed total IgE than those with insufficient (2.74 ± 0.69) and sufficient (2.72 ± 0.72) serum 25(OH)D levels (p < 0.001). The proportion of subjects with elevated IgE was higher in vitamin D-deficient (43.2%) than vitamin D-sufficient (20.0%) groups.

Conclusions: Vitamin D deficiency and insufficiency are prevalent in Hong Kong Chinese children. Vitamin D deficiency is associated with childhood AD and high total IgE. Serum 25(OH)D levels correlate inversely with both long- and short-term AD severity.

Keywords: atopic dermatitis; atopy; children; eczema; severity; vitamin D.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Biomarkers / blood
  • Case-Control Studies
  • Child
  • China
  • Dermatitis, Atopic / epidemiology*
  • Dermatitis, Atopic / immunology
  • Disease Progression
  • Eosinophils / immunology*
  • Female
  • Follow-Up Studies
  • Humans
  • Immunity, Innate
  • Immunoglobulin E / blood
  • Male
  • Time Factors
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D Deficiency / epidemiology*
  • Vitamin D Deficiency / immunology


  • Biomarkers
  • Vitamin D
  • Immunoglobulin E
  • 25-hydroxyvitamin D