Assessing the Relationship Between Vitiligo and Cardiovascular Disease Risk Factors

Abstract

Advancements in novel combination immunotherapies as well as innovative downstream management courses offer great optimism for the applicability of emerging cancer immunotherapy to prospective treatment of cold tumours. This review comprehensively analyses and discusses notable current research directions in the field and underscores future directions for continued scientific progress alongside relevant clinical applications. Vitiligo is an autoimmune disorder characterised by white depigmented cutaneous macules. Although vitiligo may generally be considered a cosmetic disease, literature has associated broader systemic comorbidities, including a higher risk for atherosclerotic events, dyslipidaemia, and cardiovascular risk. To the authors’ knowledge, this is the first systematic review that assesses the association between vitiligo and cardiovascular disease (CVD)/CVD-associated factors. Utilising the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the authors searched PubMed and Scopus databases to identify studies available as of 30th June 2022, examining CVD and CVD-associated risk factors in patients with vitiligo. Of 2,553 articles, seven studies (four cross-sectional and three case-control), totalling 611 patients diagnosed with vitiligo (56.3% female), met the inclusion criteria for the authors’ review. Six studies suggested a significant association between patients with vitiligo and an increased risk for CVD via increased atherosclerotic events, constraint-induced movement therapy, plaque presence, dyslipidaemia, high-sensitivity C-reactive protein, oxidative stress, as well as decreased levels of vitamin D, calcium, zinc, and antioxidants. However, one study found that patients with vitiligo presented with fewer cardiovascular risk factors and increased levels of high-density lipoprotein. Although few studies indicated an increase in atherosclerotic risk due to elevated low-density lipoprotein-cholesterol and total cholesterol, contradictory high-density lipoprotein and total cholesterol levels in additional studies indicate the need for further investigation. Lastly, the association between vitiligo severity and CVD risk also indicated conflicting results. The authors’ small sample size restrained their ability to compare populations and incorporate racial and ethnic diversity to generalise their conclusions. Additional studies are required to comprehensively understand the association between vitiligo and the risk of CVD.