Systematic evidence grading evaluates multisystemic associations and risks of vitiligo

Vitiligo, a chronic autoimmune skin disorder characterized by refractory depigmentation, has inconsistent associations with various biomarkers and diseases due to confounding factors. Here, we conduct a comprehensive umbrella review and comparative analysis to evaluate the validity and strength of e...

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Bibliographic Details
Published in:Nature communications Vol. 16; no. 1; pp. 9665 - 12
Main Authors: Liu, Lin, Xue, Yuzhou, Liu, Wan, Cui, Jun, Lv, Haozhen, Chang, Jianmin
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 03.11.2025
Nature Publishing Group
Nature Portfolio
Subjects:
692/499
692/53/2421
692/699/4033/4034
Autoimmune Diseases
Biomarkers
Cancer
Cataracts
Comparative analysis
Glaucoma
Graves' disease
Health risks
Humanities and Social Sciences
Humans
Inflammatory bowel disease
Inflammatory bowel diseases
Lupus
Mendelian Randomization Analysis
Meta-analysis
Meta-Analysis as Topic
Metabolic syndrome
multidisciplinary
Neoplasms - epidemiology
Neurology
Observational studies
Psychiatry
Randomization
Risk
Risk Factors
Science
Science (multidisciplinary)
Skin diseases
Thyroid
Vitiligo
Vitiligo - epidemiology
Vitiligo - genetics
ISSN:2041-1723, 2041-1723
Online Access:Get full text
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Summary:Vitiligo, a chronic autoimmune skin disorder characterized by refractory depigmentation, has inconsistent associations with various biomarkers and diseases due to confounding factors. Here, we conduct a comprehensive umbrella review and comparative analysis to evaluate the validity and strength of evidence from observational studies on vitiligo. 103 meta-analyses and 150 Mendelian randomization (MR) analyses are included, spanning categories including cardiometabolism, cancer, autoimmune, dermatosis, psychiatry/neurology/senses, and biomarkers/lifestyle. Evidence grading reveals seven convincing meta-analysis findings: five factors (fasting blood glucose, Graves’ disease, thyroid antibodies, cataracts, and glaucoma) are associated with an increased risk of vitiligo, while vitiligo is related to two conditions (a decreased risk of overall cancer and an increased risk of inflammatory bowel disease). Future similar research is unlikely to alter these findings according to fail-safe number. Among them, the protective effect of vitiligo on overall cancer risk is also supported by causal associations from MR evidence, indicating a reassuring cancer risk in vitiligo. This study establishes an evidence hierarchy for vitiligo, which may inform multidisciplinary management strategies. Vitiligo, a chronic autoimmune skin disorder, has inconsistent associations with various biomarkers and diseases due to confounding factors. Here, the authors conduct an umbrella review and comparative analysis of meta-analyses and Mendelian randomization studies to evaluate the strength and validity of evidence on multisystemic associations with vitiligo.
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ISSN:2041-1723
2041-1723
DOI:10.1038/s41467-025-64653-y