Tetik Dincer Busra, Ozcelik Gul, Urganci Nafiye
Department of Pediatrics, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Division of Pediatric Nephrology, Department of Pediatrics, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Sisli Etfal Hastan Tip Bul. 2024 Sep 30;58(3):359-362. doi: 10.14744/SEMB.2024.86461. eCollection 2024.
Familial Mediterranean fever (FMF) is an autoinflammatory disease more commonly observed in the Eastern Mediterranean region. Studies have shown that inflammatory processes may decrease vitamin D, vitamin B12 and folate levels, but there is no clear data on the effect of attack frequency on these levels. Our study aimed to evaluate the effect of FMF attack frequency on vitamin levels.
FMF patients aged between 4-18 years were considered as the study group, while healthy children who had vitamin levels during the same period were considered as the control group. The study group was further subgrouped according to the number of attacks. Those experiencing 2 or fewer attacks per year are classified as the attack group, while those experiencing 6 or more attacks per year are classified as the frequent attack group.
A total of 494 subjects were included. The study group was composed of 333 FMF patients, 108 of them in the attack group and 225 in the frequent attack group. Control group included 161 children. The median and interquartile range (IQR: P25-75) in the frequent attack, attack, and control groups for 25(OH)D levels were 14.3 (9.57-18.9), 14.85 (10.12-21.77), and 14.95 (9.92-20.12) ng/ml, for B12 levels were 320 (238-415), 328 (250.25-439.25), and 373 (273.75-519.25) pg/ml, and for folate levels were 6 (5.13-8.12), 6.8 (5.36-8.9), and 7 (5.3-9.9) ng/ml, respectively. There is no significant difference between groups for 25(OH)D and folate (p=0.436 and p=0.25, respectively). Vitamin B12 levels are significantly lower in study group (p=0.001) but there is no difference according to attack frequency (p=0.92).
There is no effect of attack frequency on 25(OH)D, vitamin B12 and folate levels. The fact that vitamin B12 levels are within normal limits in patients with FMF may be explained by the adequate dietary habits of these patients.
家族性地中海热（FMF）是一种自身炎症性疾病，在地中海东部地区更为常见。研究表明，炎症过程可能会降低维生素D、维生素B12和叶酸水平，但关于发作频率对这些水平的影响尚无明确数据。我们的研究旨在评估FMF发作频率对维生素水平的影响。
将4至18岁的FMF患者作为研究组，同时将同期维生素水平正常的健康儿童作为对照组。研究组根据发作次数进一步细分。每年发作2次或更少的患者归为发作组，而每年发作6次或更多的患者归为频繁发作组。
共纳入494名受试者。研究组由333名FMF患者组成，其中108名在发作组，225名在频繁发作组。对照组包括161名儿童。频繁发作组、发作组和对照组的25（OH）D水平中位数及四分位间距（IQR：P25 - 75）分别为14.3（9.57 - 18.9）、14.85（10.12 - 21.77）和14.95（9.92 - 20.12）ng/ml，B12水平分别为320（238 - 415）、328（250.25 - 439.25）和373（273.75 - 519.25）pg/ml，叶酸水平分别为6（5.13 - 8.12）、6.8（5.36 - 8.9）和7（5.3 - 9.9）ng/ml。25（OH）D和叶酸水平在各组之间无显著差异（p分别为0.436和0.25）。研究组的维生素B12水平显著较低（p = 0.001），但根据发作频率无差异（p = 0.92）。
发作频率对25（OH）D、维生素B12和叶酸水平无影响。FMF患者维生素B12水平在正常范围内这一事实，可能可以用这些患者适当的饮食习惯来解释。
