Investigation of serum vitamin D levels and vitamin D reseptor (VDR) gene polymorphisms in patients with acne vulgaris

BOZKURT A. Investigation of serum Vitamin D Levels and Vitamin D Reseptor (VDR) gene polymorphisms in patients with acne vulgaris. Ege University Faculty of Medicine, Department of Dermatology and Venereology. Thesis of Specialty, İzmir, 2015. Aim: Acne vulgaris is a chronic inflammatory disease of pilosebaseous unite. It's characterized by wide range of clinical pictures showing recurrance and aggrevation. Pathogenesis of acne has not been clearly elucidated but four main factors are considered to play major roles in etiology. These factors are; comedogenesis, increased sebaseous gland hyperplasia and sebum production, hypercolonisation of the follicle by Proprionibacterium acnes and induction of inflammatory response. Vitamin D is a steroid-derived hormone which is known classically for its role in bone mineralisation and calcium-phosphate homeostasis. Recently it has been discovered that vitamin D has some additional immunmodulatory, antiinflammatory, antimicrobial effects in skin cells and regulatory effects in sebaceous glands. Most biologic effects of vitamin D is occured by means of vitamin D receptor (VDR). VDR gene is located 12q13.1 region and sized about 100 kb. Until today more than 470 polymorphisms has been discovered in VDR gene. Bsm I ve Fok I are one of the most common polymorphisms of VDR gene. In our study we aimed to show if there is a significant difference in serum levels of vitamin D and VDR gene Fok I and Bsm I polymorphisms in acne patients. Materials and Methods: Patients diagnosed with acne vulgaris and healthy subjects aged between 18 and 45 years with no chronic systemic disease administered at Ege Unıversity Medical Faculty Hospital Dermatology outpatient clinics from December 2013 to January 2015 were included in the study. Blood samples were collected. PCR and gel electrophoresis is used to detect VDR gene for Fok I and Bsm I polymorphis. ELİSA method is used for measurement of blood vitamin D level. We performed a case-control study. Results: We evaluated 80 patients (40 female/40 male) diagnosed with acne vulgaris and 100 healthy volunteers (49 female/51 male) as a control group. There were no significant differences between the study groups in relation to age, body mass index and sex distribution. Demographic and clinical features of the patients were recorded. Median serum vitamin D levels of patient group and control group were 19,62 ± 7,66 ng/ml and 20,39 ± 7,11 ng/ml, respectively. There was no significant difference between patient group and control group for serum vitamin D level (p=0,484). FF 43,8%, FF 47,5%, 8,8% genotype percents were found in patients and FF 41,0%, Ff 49,0%, ff 10,0% in control group that has Fok I polymorphism. There was no significant difference in genotypic frequencies between patient and control group according to the Fok I polymorphism (p=0,917). F 67,5%, f 32,5% allele percents were found in patients and F 65,5%, f 34,5% in control group that has Fok I polymorphism. There was no significant difference in allelic frequencies between patient and control group according to the Fok I polymorphism (p=0,388). BB 13.3%, Bb 51,4%, bb 35,2% genotype percents were found in patients and BB 13,0%, Bb 53,0%; bb 34,0% in control group that has Bsm I polymorphism. There was no significant difference in genotypic frequencies between patient and control group according to the Bsm I polymorphism (p=0,915). B 39,0%, b 61,0% allele percents were in found in patients and B 39,5%, b 60,5% in control group that has Bsm I polymorphism. There was no significant difference in allelic frequencies between patient and control group according to the Bsm I polymorphism (p=0,391). Conclusion: We couldn't find significant difference in serum vitamin D levels and VDR gene Fok I ve Bsm I polymorphisms between patients diagnosed with acne vulgaris and control group. We failed to show the role of vitamin D and Bsm I ve Fok I polymorphisms in acne pathogenesis. Key words: Acne vulgaris, Vitamin D, VDR polymorphism, Fok I, Bsm I