Çocuk Yoğun Bakım Hastalarında Serum D Vitamini Konsantrasyonu ile Hemogramdan Türetilmiş Yeni İnflamatuar Biyobelirteçler Arasındaki İlişki

Abstract

Giriş: Klasik kemik metabolizması bozukluklarının yanı sıra D vitamini, inflamasyon ve D vitamini eksikliği ile ilişkili birçok hastalığın patogenezini açıklayabilir. Çok sayıda araştırma D vitamininin iltihaplanma ile ilişkisini desteklerken, bazı araştırmalar bu ilişkiyi doğrulamamaktadır. Hemogramdan Türetilmiş Yeni İnflamatuar Biyobelirteçler, tüm merkezlerde çalışılabilecek yeni ve ucuz inflamasyon belirteçleridir. Bu çalışmanın amacı, 25-hidroksi D vitamini (25(OH)D) ile yeni inflamatuar belirteçler ile inflamasyon arasındaki ilişkiyi araştırmaktır. Gereç ve yöntemler: Bu çalışma prospektif olarak yürütüldü ve Çocuk Yoğun bakım Ünitesinde tedavi gören 77 hastanın verileri dahil edildi. Eş zamanlı çalışılan 25(OH)D3, kalsiyum, fosfor ve tam kan sayımı sonuçları kaydedildi. Hemogramdan türetilmiş yeni inflamatuar biyobelirteçler, sistemik inflamatuar yanıt indeksi (SIRI) ve sistemik immün inflamatuar indeks (SII) hesaplandı. Bulgular: D vitamini eksikliği olan ve olmayan gruplar arasında hemogramdan türetilmiş yeni inflamatuar biyobelirteçler açısından anlamlı fark bulunmadı (tümü için p>0,05). Sonuçlar: Çalışmamız, bu ucuz ve evrensel olarak bulunabilen biyobelirteçler ile D vitamini düzeyleri ve inflamasyon arasında istatistiksel bir ilişki varlığını ortaya koymamıştır. Daha fazla sayıda denek ile bulguların geçerliği doğrulanmalıdır.

Keywords

• sistemik inflamatuar indeks
• sistemik inflamatuar yanıt indeksi
• D vitamini
• çocuk yoğun bakım

The Relationship Between Newly Derived Inflammatory Biomarkers from Hemogram and Serum Vitamin D Concentration in Pediatric Intensive Care Patients

Abstract

Introduction: Besides classical disorders of bone metabolism, vitamin D may explain the pathogenesis of many diseases associated with inflammation and vitamin D deficiency. While numerous studies support vitamin D's relationship with inflammation, some studies do not confirm this relationship. Novel Hemogram-Derived Inflammatory Biomarkers are new and inexpensive markers of inflammation that can be tested in all centers. The aim of this study is to investigate the relationship between 25-hydroxyvitamin D (25(OH)D) and new inflammatory markers and inflammation. Material and methods: This study was conducted prospectively and data from 77 patients treated in the Pediatric Intensive Care Unit were included. Simultaneous 25(OH)D3, calcium, phosphorus and complete blood count results were recorded. Novel hemogram-derived inflammatory biomarkers, systemic inflammatory response index (SIRI) and systemic immune inflammatory index (SII), were calculated. Results: There was no significant difference in hemogram-derived new inflammatory biomarkers between groups with and without vitamin D deficiency (p>0.05 for all). Conclusions: Our study did not reveal a statistical association between these inexpensive and universally available biomarkers and vitamin D levels and inflammation. The validity of the findings should be confirmed with a larger number of subjects.

Keywords

• systemic inflammatory index
• systemic inflammatory response index
• vitamin D
• pediatric intensive care

References

1. 1. Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266-81.
2. 2. Makhsudov J, Yilmaz R. Vitamin D Deficiency in Children [in Turkish]. Chronicles of Precision Medical Researchers. 2020;1(1):8-19.
3. 3. Pittas AG, Harris SS, Stark PC, Dawson-Hughes B. The effects of calcium and vitamin D supplementation on blood glucose and markers of inflammation in nondiabetic adults. Diabetes Care. 2007;30(4):980-6.
4. 4. Gul A, Ozer S, Yilmaz R, Sonmezgoz E, Kasap T, Takci S, et al. Association between vitamin D levels and cardiovascular risk factors in obese children and adolescents. Nutr Hosp. 2017;34(2):323-9.
5. 5. Wu S, Sun J. Vitamin D, vitamin D receptor, and macroautophagy in inflammation and infection. Discov Med. 2011;11(59):325-35.
6. 6. Sonmezgoz E, Ozer S, Yilmaz R, Onder Y, Butun I, Bilge S. [Hypovitaminosis D in Children with Hashimoto’s Thyroiditis]. Rev Med Chil. 2016;144(5):611-6.
7. 7. Ismailova A, White JH. Vitamin D, infections and immunity. Rev Endocr Metab Disord. 2022;23(2):265-77.
8. 8. Han QQ, Yu J. Inflammation: a mechanism of depression? Neurosci Bull. 2014;30(3):515-23.

9. 9. Ferrucci L, Fabbri E. Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty. Nat Rev Cardiol. 2018;15(9):505-22.
10. 10. Tsalamandris S, Antonopoulos AS, Oikonomou E, Papamikroulis GA, Vogiatzi G, Papaioannou S, et al. The Role of Inflammation in Diabetes: Current Concepts and Future Perspectives. Eur Cardiol. 2019;14(1):50-9.
11. 11. Yi YS. Role of inflammasomes in inflammatory autoimmune rheumatic diseases. Korean J Physiol Pharmacol. 2018;22(1):1-15.
12. 12. Greten FR, Grivennikov SI. Inflammation and Cancer: Triggers, Mechanisms, and Consequences. Immunity. 2019;51(1):27-41.
13. 13. Tiosano D, Wildbaum G, Gepstein V, Verbitsky O, Weisman Y, Karin N, et al. The role of vitamin D receptor in innate and adaptive immunity: a study in hereditary vitamin D-resistant rickets patients. J Clin Endocrinol Metab. 2013;98(4):1685-93.
14. 14. Yin K, Agrawal DK. Vitamin D and inflammatory diseases. Journal of inflammation research. 2014:69-87.
15. 15. Sharifi A, Vahedi H, Nedjat S, Rafiei H, Hosseinzadeh-Attar MJ. Effect of single-dose injection of vitamin D on immune cytokines in ulcerative colitis patients: a randomized placebo-controlled trial. APMIS. 2019;127(10):681-7.
16. 16. Miroliaee AE, Salamzadeh J, Shokouhi S, Sahraei Z. The study of vitamin D administration effect on CRP and Interleukin-6 as prognostic biomarkers of ventilator associated pneumonia. J Crit Care. 2018;44:300-5.
17. 17. Zittermann A, Dembinski J, Stehle P. Low vitamin D status is associated with low cord blood levels of the immunosuppressive cytokine interleukin-10. Pediatr Allergy Immunol. 2004;15(3):242-6.
18. 18. Altaş EU, Tosun A. Assessment of Vitamin D and inflammatory response relationship using neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and mean platelet volume. Turk Osteoporoz Dergisi. 2018;24(1):11.
19. 19. Akbas EM, Gungor A, Ozcicek A, Akbas N, Askin S, Polat M. Vitamin D and inflammation: evaluation with neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio. Arch Med Sci. 2016;12(4):721-7.
20. 20. Coşkun C, Şahin K. Correlation between vitamin D level and platelet indices in children aged 0-18 years. Haseki Tip Bulteni. 2018;56(2):153.
21. 21. Otero TMN, Monlezun DJ, Christopher KB, Camargo CA, Quraishi SA. Vitamin D Status and Elevated Red Cell Distribution Width in Community-Dwelling Adults: Results from the National Health and Nutrition Examination Survey 2001-2006. J Nutr Health Aging. 2017;21(10):1176-82.
22. 22. Turkmen K, Erdur FM, Ozcicek F, Ozcicek A, Akbas EM, Ozbicer A, et al. Platelet-to-lymphocyte ratio better predicts inflammation than neutrophil-to-lymphocyte ratio in end-stage renal disease patients. Hemodial Int. 2013;17(3):391-6.
23. 23. Sunbul M, Gerin F, Durmus E, Kivrak T, Sari I, Tigen K, et al. Neutrophil to lymphocyte and platelet to lymphocyte ratio in patients with dipper versus non-dipper hypertension. Clin Exp Hypertens. 2014;36(4):217-21.
24. 24. Akbas EM, Demirtas L, Ozcicek A, Timuroglu A, Bakirci EM, Hamur H, et al. Association of epicardial adipose tissue, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with diabetic nephropathy. Int J Clin Exp Med. 2014;7(7):1794-801.
25. 25. Taylor MH, Takahashi S, Capdevila J, Tahara M, Leboulleux S, Kiyota N, et al. Correlation of Performance Status and Neutrophil-Lymphocyte Ratio with Efficacy in Radioiodine-Refractory Differentiated Thyroid Cancer Treated with Lenvatinib. Thyroid. 2021;31(8):1226-34.
26. 26. Gary T, Pichler M, Belaj K, Hafner F, Gerger A, Froehlich H, et al. Platelet-to-lymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients. PLoS One. 2013;8(7):e67688.
27. 27. Geng Y, Zhu D, Wu C, Wu J, Wang Q, Li R, et al. A novel systemic inflammation response index (SIRI) for predicting postoperative survival of patients with esophageal squamous cell carcinoma. Int Immunopharmacol. 2018;65:503-10.
28. 28. Dziedzic EA, Gąsior JS, Tuzimek A, Paleczny J, Junka A, Dąbrowski M, et al. Investigation of the Associations of Novel Inflammatory Biomarkers-Systemic Inflammatory Index (SII) and Systemic Inflammatory Response Index (SIRI)-With the Severity of Coronary Artery Disease and Acute Coronary Syndrome Occurrence. Int J Mol Sci. 2022;23(17).
29. 29. Dziedzic EA, Gąsior JS, Tuzimek A, Dąbrowski M, Jankowski P. The Association between Serum Vitamin D Concentration and New Inflammatory Biomarkers-Systemic Inflammatory Index (SII) and Systemic Inflammatory Response (SIRI)-In Patients with Ischemic Heart Disease. Nutrients. 2022;14(19).
30. 30. Huang X, Xu M, Wang Y, Zhang Z, Li F, Chen X, et al. The systemic inflammation markers as possible indices for predicting respiratory failure and outcome in patients with myasthenia gravis. Ann Clin Transl Neurol. 2023;10(1):98-110.
31. 31. Adams JS, Hewison M. Update in vitamin D. J Clin Endocrinol Metab. 2010;95(2):471-8.
32. 32. Alrefai D, Jones J, El-Matary W, Whiting SJ, Aljebreen A, Mirhosseini N, et al. The Association of Vitamin D Status with Disease Activity in a Cohort of Crohn's Disease Patients in Canada. Nutrients. 2017;9(10).
33. 33. Mathur J, Naing S, Mills P, Limsui D. A randomized clinical trial of vitamin D(3) (cholecalciferol) in ulcerative colitis patients with hypovitaminosis D(3). PeerJ. 2017;5:e3654.
34. 34. Yilmaz R, Karaaslan E, Albayrak SE, Gul A, Kasap T. Effect of platelet activity markers on patients admitted to children's intensive care unit due to Crimean-Congo hemorrhagic fever: Platelet activity markers and Crimean-Congo hemorrhagic fever. Chronicles of Precision Medical Researchers. 2021;2(1):13-8.
35. 35. Tabatabaeizadeh SA, Avan A, Bahrami A, Khodashenas E, Esmaeili H, Ferns GA, et al. High Dose Supplementation of Vitamin D Affects Measures of Systemic Inflammation: Reductions in High Sensitivity C-Reactive Protein Level and Neutrophil to Lymphocyte Ratio (NLR) Distribution. J Cell Biochem. 2017;118(12):4317-22.
36. 36. Mirchi E, Saghafi H, Gharehbeglou M, Aghaali M, Rezaian Z, Ghaviahd M. Association Between 25-Hydroxyvitamin D Level and Inflammatory and Nutritional Factors in Hemodialysis and Peritoneal dialysis Patients in Qom, Iran. Iran J Kidney Dis. 2016;10(4):205-12.
37. 37. Yildirim I, Hur E, Kokturk F. Inflammatory Markers: C-Reactive Protein, Erythrocyte Sedimentation Rate, and Leukocyte Count in Vitamin D Deficient Patients with and without Chronic Kidney Disease. Int J Endocrinol. 2013;2013:802165.
38. 38. Kim M, Na W, Sohn C. Correlation between vitamin D and cardiovascular disease predictors in overweight and obese Koreans. J Clin Biochem Nutr. 2013;52(2):167-71.
39. 39. Flad HD, Brandt E. Platelet-derived chemokines: pathophysiology and therapeutic aspects. Cell Mol Life Sci. 2010;67(14):2363-86.
40. 40. Jiang Z, Jiang X, Chen A, He W. Platelet activation: a promoter for psoriasis and its comorbidity, cardiovascular disease. Front Immunol. 2023;14:1238647.
41. 41. Vagionas D, Papadakis DD, Politou M, Koutsoukou A, Vasileiadis I. Thromboinflammation in Sepsis and Heparin: A Review of Literature and Pathophysiology. In Vivo. 2022;36(6):2542-57.
42. 42. Sobolewska A, Włodarczyk M, Stec-Michalska K, Fichna J, Wiśniewska-Jarosińska M. Mean Platelet Volume in Crohn's Disease Patients Predicts Sustained Response to a 52-Week Infliximab Therapy: A Pilot Study. Dig Dis Sci. 2016;61(2):542-9.
43. 43. Elgormus Y, Okuyan O, Uzun H. The relationship between hematological indices as indicators of inflammation and 25-hydroxyvitamin D3 status in newborns. BMC Pediatr. 2023;23(1):83.
44. 44. Erkus E, Aktas G, Atak BM, Kocak MZ, Duman TT, Savli H. Haemogram Parameters in Vitamin D Deficiency. J Coll Physicians Surg Pak. 2018;28(10):779-82.
45. 45. Alkan G, Sert A, Emiroglu M, Tuter Oz SK, Vatansev H. Evaluation of hematological parameters and inflammatory markers in children with COVID-19. Ir J Med Sci. 2022;191(4):1725-33.
46. 46. Konuksever D, Yücel Karakaya SP, Bölük O, Koçak M, Kılıç BO, Saç R. The association of vitamin D deficiency with hemogram-derived inflammatory biomarkers in children. Nutr Metab Cardiovasc Dis. 2022;32(10):2418-23.