Estimation of serum levels of Parathyroid hormone, Vitamin D, Calcium and Phosphorus to study their association with age, gender, disease duration, and severity of chronic plaque psoriasis: Results of a case control study

Abstract

: Psoriasis is a chronic inflammatory disease characterized by rapid turnover of epidermal keratinocytes; presenting clinically as erythema, induration, and scaling Parathyroid hormone (PTH) is secreted by parathyroid glands and its elevated levels may be seen in psoriasis and several other disorders of keratinization. PTH/PTH-related peptide receptors are present in dermal fibroblasts & regulate proliferation and maturation of fibroblasts and  keratinocytes. Release of PTH is under the feedback  regulation of serum Ca2+, Vit.D and PO: To assess the Parathyroid hormone levels in patients of Psoriasis along with Vitamin D, Serum Calcium and Serum Phosphorus levels.: Out of the 50 cases aged between 18 and 91 years majority of patients i.e 22 (44%) were in the age group of 18-40 years followed by 20 (40%) patients in 41-60 years age group. Eight (16%) patients were above >60 years. 32 (64%) patients who had psoriasis for less than ≤60 months while 18 (36%) patients had psoriasis for more than >60 months Serum PTH (normal 10–65pg/ml), Vitamin D(normal 20-50(ng/ml), calcium (normal 9-11mg/dl and phosphorus (normal 2.5-4.5mg/dl) levels were measured after overnight fasting. : A total of 50 psoriasis patients along with 50 non-psoriatic age and sex matched controls were recruited for the study. There were 28 males and 22 females in the patient group aged between 18 and 91 years (mean±SD 43.52±16.23 years). The mean age of controls was 47.12±16.29 years with 19(38%) subjects in 18-40 years age group and 21(42%) in 41-60 years age group. Amongst the cases, there were 10(20%) patients who had abnormal PTH levels (six had elevated levels of PTH and four patients with low PTH levels) while 40(80%) had normal levels (mean±SD 47.97±25.46 pg/ml). : The interpretation of our observation remains complex and any conclusion for the significance of these biochemical abnormalities remain conjectural. Moreover, association of psoriasis with abnormal biochemical parameters remains debatable in view of limited number of studies whether abnormal biochemical parameters can serve as markers of severity and their correction can lead to improvement in the disease needs confirmation with more well designed experimental and prospective clinical studies.