Pediatrics, Turkish Ministry of Health Ankara City Hospital, Bilkent, Ankara, Turkey.
Department of Biostatistics, Cukurova University, Adana, Turkey.
Nutr Metab Cardiovasc Dis. 2022 Oct;32(10):2418-2423. doi: 10.1016/j.numecd.2022.07.012. Epub 2022 Jul 31.
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.
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.
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.
维生素 D 的一种骨外作用是其作为炎症过程的有效调节剂。许多研究表明维生素 D 与炎症之间呈负相关。因此,我们假设维生素 D 缺乏可能会影响来自血常规参数的炎症标志物[中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、淋巴细胞与单核细胞比值(LMR)、血小板分布宽度(PDW)、红细胞分布宽度(RDW)]。
我们对健康儿童进行了回顾性研究。从 2015 年至 2020 年,从电子病历中确定了 16321 名同时进行维生素 D 和血常规检测的儿童。根据是否存在维生素 D 缺乏,将参与者分为 2 组。分析了维生素 D 状态与炎症标志物水平之间的关系。所有炎症标志物在维生素 D 状态之间均具有统计学显著差异(p<0.001)。维生素 D 水平与 NLR(r=-0.285)、PLR(r=-0.257)、PDW(r=-0.181)显著负相关,与 LMR(r=0.218)和 RDW(r=0.057)显著正相关。在逻辑回归分析中,年龄(OR=1.15,95%CI:1.14-1.16)、性别(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)和 RDW(OR=1.10,95%CI:1.07-1.13)被发现是维生素 D 缺乏的独立预测因子。
维生素 D 状态与炎症参数之间存在统计学显著差异。然而,维生素 D 组中位数之间的差异非常小,相关性非常弱。因此,应该质疑这种差异的临床意义。