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Association of vitamin D status with novel hemogram-derived inflammatory indices in preterm infants
Dilek Kurnaz1, Ayşe Işıl Özsoy2, Zeynep Üze Okay2
1Department of Pediatrics, Division of Neonatology, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye. drdilekkurnaz@gmail.com.
Insights
Vitamin D levels did not correlate with common inflammatory markers in preterm infants. Further research is needed to understand vitamin D’s role in neonatal immune responses.
Area of Science:
- Neonatalogy
- Immunology
- Nutritional Science
Background:
- Vitamin D is crucial for immune regulation and inflammatory responses.
- Hemogram-derived inflammatory indices (e.g., NLR, PLR, SII) are emerging markers of systemic inflammation.
- Limited data exist on vitamin D status and these inflammatory markers in preterm infants.
Purpose of the Study:
- To investigate the association between vitamin D levels and hemogram-derived inflammatory indices in preterm infants.
- To assess vitamin D status (deficiency, insufficiency, sufficiency) in hospitalized preterm infants.
Main Methods:
- Retrospective analysis of 212 preterm infants (≤34 weeks gestation).
- Serum 25-hydroxyvitamin D [25(OH)D] and complete blood count (CBC) parameters were analyzed.
- Calculation and comparison of inflammatory indices (NLR, PLR, SII, SIRI, AISI) across vitamin D groups.
Main Results:
- Mean vitamin D level was 15.4 ng/mL; 44.3% were deficient.
- No significant differences in inflammatory indices (WBC, CRP, NLR, PLR, SII, SIRI, AISI) were found across vitamin D groups (p > 0.05).
- No significant correlations were observed between vitamin D levels and inflammatory indices.
Conclusions:
- Vitamin D status showed no association with hemogram-derived inflammatory indices in preterm infants.
- This lack of association persisted after adjusting for perinatal confounders.
- Further prospective studies are required to elucidate the vitamin D-inflammation relationship in this vulnerable population.
Background:
Vitamin D plays an important role in immune regulation and inflammatory responses. Hemogram-derived inflammatory indices such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) have recently emerged as practical markers of systemic inflammation. However, data regarding the relationship between vitamin D status and these inflammatory indices in preterm infants are limited.
Objective:
To evaluate the association between vitamin D levels and hemogram-derived inflammatory indices in preterm infants hospitalized in the neonatal intensive care unit.
Methods:
This retrospective study included 212 preterm infants born at or below 34 weeks of gestation. Serum 25-hydroxyvitamin D [25(OH)D] levels obtained during the first postnatal week and complete blood count (CBC) parameters measured on the first day of life were analyzed. Infants were classified as vitamin D deficient (< 12 ng/mL), insufficient (12-20 ng/mL), or sufficient (≥ 20 ng/mL). Hemogram-derived inflammatory indices including NLR, PLR, monocyte-to-lymphocyte ratio (MLR), SII, SIRI, and AISI were calculated and compared between groups.
Results:
The mean vitamin D level was 15.4 ± 10.3 ng/mL. Vitamin D deficiency, insufficiency, and sufficiency were detected in 44.3%, 27.8%, and 27.8% of infants, respectively. No significant differences were observed among vitamin D groups regarding WBC (White Blood Cell), C-reactive protein (CRP), NLR, PLR, MLR, SII, SIRI, or AISI values (all p > 0.05). Similarly, no significant correlations were found between vitamin D levels and inflammatory indices. Infants born before 32 weeks' gestation had significantly higher NLR, SII, SIRI, and AISI values compared with infants ≥ 32 weeks (all p < 0.01).
Conclusion:
Vitamin D status was not associated with hemogram-derived inflammatory indices in preterm infants, even after adjustment for relevant perinatal confounders. Further prospective studies are needed to clarify the relationship between vitamin D status and inflammatory profiles in this population.
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