{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T18:49:41Z","timestamp":1776365381615,"version":"3.51.2"},"update-to":[{"DOI":"10.1371\/journal.pntd.0014205","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000}}],"reference-count":53,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100021726","name":"Direktorat Riset and Pengembangan, Universitas Indonesia","doi-asserted-by":"publisher","award":["NKB-689\/UN2.RST\/HKP.05.00\/2023"],"award-info":[{"award-number":["NKB-689\/UN2.RST\/HKP.05.00\/2023"]}],"id":[{"id":"10.13039\/501100021726","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Alterations in the vitamin D axis have been implicated in chronic wounds, but their role in leprosy-related trophic ulcers (TU) is unclear. This study compared serum vitamin D levels and\n                      <jats:italic>VDR FokI<\/jats:italic>\n                      (rs2228570) polymorphism between leprosy patients with and without TU, assessed their association with ulcer presence, and examined the correlation between vitamin D levels and ulcer severity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This case-control study involved 82 adult leprosy patients (41 with TU, 41 without) treated at a tertiary referral hospital in Jakarta, Indonesia. Serum 25-hydroxyvitamin D [25(OH)D] levels were measured using chemiluminescence assay, and\n                      <jats:italic>FokI<\/jats:italic>\n                      polymorphism was analyzed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Ulcer severity was evaluated using the Pressure Ulcer Scale for Healing (PUSH). Associations were assessed through bivariate and multivariate analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with TU had significantly lower mean serum 25(OH)D levels than those without TU (13.14 vs. 20.18 ng\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The homozygous mutant\n                      <jats:italic>FokI<\/jats:italic>\n                      genotype (\n                      <jats:italic>ff<\/jats:italic>\n                      ) was more frequent in the TU group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043). In multivariable analysis, both low vitamin D status (adjusted odds ratio [aOR] 4.15; 95% confidence interval [CI] 1.41\u201312.24;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010) and the\n                      <jats:italic>FokI<\/jats:italic>\n                      polymorphism (aOR 7.86; 95% CI 1.80\u201334.36;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006) remained independently associated with TU. Vitamin D levels showed a weak inverse correlation with PUSH scores (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u20130.312,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Lower serum vitamin D status and the\n                      <jats:italic>FokI<\/jats:italic>\n                      polymorphism were independently associated with TU in leprosy, and a weak inverse correlation was observed between serum vitamin D levels and ulcer severity. While genetic variation is non-modifiable, vitamin D status represents a potentially modifiable factor; hence, these findings suggest that assessment of vitamin D status may be considered as part of comprehensive ulcer care in leprosy.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0014205","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T17:44:03Z","timestamp":1775843043000},"page":"e0014205","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of serum vitamin D level and vitamin D receptor gene FokI polymorphism in leprosy patients with and without trophic ulcers: A case-control study"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0754-1104","authenticated-orcid":true,"given":"Paulus 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