Causal Associations between Vitamin D Levels and Psoriasis, Atopic Dermatitis, and Vitiligo: A Bidirectional Two-Sample Mendelian Randomization Analysis

Abstract

Background: Vitamin D level has been reported to be associated with psoriasis, atopic dermatitis, and vitiligo. However, its causal relationship with the risk of these three diseases remains unclear. Methods: We obtained genome-wide association statistics for three measures of circulating vitamin D levels (25(OH)D in 120,618 individuals, and 25(OH)D3 and epimeric form C3-epi-25(OH)D3 in 40,562 individuals) and for the diseases psoriasis (3871 cases and 333,288 controls), atopic dermatitis (21,399 cases and 95,464 controls), and vitiligo (4680 cases and 39,586 controls). We performed Mendelian randomization using inverse-variance weighted, weighted median, MR-Egger, and MR-pleiotropy residual sum and outlier methods. We carried out sensitivity analyses to evaluate the robustness of the results. Results: We showed that elevated vitamin D levels protected individuals from developing psoriasis (OR = 0.995, p = 8.84 × 10−4 for 25(OH)D; OR = 0.997, p = 1.81 × 10−3 for 25(OH)D3; and OR = 0.998, p = 0.044 for C3-epi-25(OH)D3). Genetically predicted risk of atopic dermatitis increased the levels of 25(OH)D (OR = 1.040, p = 7.14 × 10−4) and 25(OH)D3 (OR = 1.208, p = 0.048). A sensitivity analysis suggested the robustness of these causal associations. Conclusions: This study reported causal relationships between circulating vitamin D levels and the risk of psoriasis, atopic dermatitis, and vitiligo. These findings provide potential disease intervention and monitoring targets.