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The association of vitamin D deficiency with hemogram-derived inflammatory biomarkers in children
Dilek Konuksever1, Sevinç Püren Yücel Karakaya2, Oğuz Bölük3
1Pediatrics, Turkish Ministry of Health Ankara City Hospital, Bilkent, Ankara, Turkey.
Insights
Vitamin D deficiency is linked to altered inflammatory markers in children, including neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). However, the clinical significance of these associations remains questionable due to weak correlations.
Area of Science:
- Pediatric Health
- Immunology
- Nutritional Science
Background:
- Vitamin D modulates inflammatory processes, with studies showing an inverse association between vitamin D levels and inflammation.
- Vitamin D deficiency may impact hemogram-derived inflammatory markers in children.
Purpose of the Study:
- To investigate the relationship between vitamin D status and inflammatory markers derived from hemogram parameters in healthy children.
- To determine if vitamin D deficiency affects neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), platelet distribution width (PDW), and red blood cell distribution width (RDW).
Main Methods:
- Retrospective study of 16,321 healthy children with simultaneous vitamin D and hemogram measurements (2015-2020).
- Participants categorized into vitamin D deficient and non-deficient groups.
- Analysis of correlations between vitamin D levels and inflammatory markers (NLR, PLR, LMR, PDW, RDW).
- Logistic regression analysis to identify independent predictors of vitamin D deficiency.
Main Results:
- Statistically significant differences in all analyzed inflammatory markers were observed between vitamin D status groups (p < 0.001).
- Vitamin D levels showed significant negative correlations with NLR, PLR, and PDW, and positive correlations with LMR and RDW.
- Age, gender, LMR, PLR, and RDW were identified as independent predictors of vitamin D deficiency.
Conclusions:
- While statistically significant differences exist between vitamin D status and inflammatory parameters, the small median value differences and weak correlations question the clinical significance.
- Further research is needed to elucidate the clinical implications of vitamin D status on pediatric inflammatory markers.
Background And Aims:
One of the extraosseous effects of vitamin D is that it is a potent modulator of inflammatory processes. Many studies have demonstrated the inverse association between vitamin D and inflammation. Therefore, we hypothesize that vitamin D deficiency may affect the inflammatory markers derived from hemogram parameters [neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), platelet distribution width (PDW), red blood cell distribution width (RDW)] in healthy children.
Methods And Results:
We conducted a retrospective study on healthy children. From 2015 to 2020, 16,321 children with simultaneous vitamin D and hemogram measurements were identified from electronic records. Participants were divided into 2 groups according to whether they had vitamin D deficiency or not. The relationship between vitamin D status and the levels of inflammatory markers was analyzed. All inflammatory markers showed statistically significant differences between vitamin D status (p < 0.001 for all). Vitamin D levels were significantly negatively correlated with NLR (r = -0.285), PLR (r = -0.257), PDW (r = -0.181), and positively correlated with LMR (r = 0.218), and RDW (r = 0.057). In logistic regression analysis, age (OR = 1.15, 95% CI: 1.14-1.16), gender (OR = 1.66, 95% CI: 1.54-1.78), LMR (OR = 0.96, 95% CI: 0.95-0.98), PLR (OR = 1.003, 95% CI: 1.001-1.004), and RDW (OR = 1.10, 95%CI: 1.07-1.13) were found to be independent predictors for vitamin D deficiency.
Conclusions:
Statistically significant differences were detected between vitamin D status and inflammatory parameters. However, the difference between the median values of vitamin D groups was very small and the degree of correlation was very weak. Therefore, the clinical significance of the difference should be questioned.
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