Primer Baş Ağrısı Olan Çocuk ve Adölesanlarda Nötrofillenfosit Oranı, Serum Ferritin, Folik Asit, B12 Vitamini ve 25-hidroksivitamin D Düzeyleri

Amaç: Baş ağrısı, genel çocuk polikliniklerinde en sık görülen şikayetlerden biridir. Bu çalışma ile birincil baş ağrısı olan çocuk ve ergenlerde, tam kan sayımı (TKS) parametreleri, 25-hidroksivitamin D [25(OH)D], ferritin, vitamin B12 ve folik asit düzeylerini araştırmayı amaçladık. Gereç ve Yöntemler: Bu çalışmada 5-18 yaş arasındaki primer baş ağrısı olan 149 hasta [migren, gerilim tipi baş ağrısı (GTBA), sınıflandırılmamış baş ağrısı] ve 104 sağlıklı kontrol retrospektif olarak değerlendirildi. Her iki grup için de yaş, cinsiyet, fizik muayene bulguları ve laboratuvar parametreleri [TKS, 25(OH)D, vitamin B12, folik asit, ferritin] kaydedildi. Bulgular: Birincil baş ağrısı grubundaki baş ağrısı tipleri GTBA (%48,1), migren (%28,2) ve sınıflandırılamayan baş ağrısı (%23,7) idi. Birincil baş ağrısı grubunda ortanca ferritin ve serum B12 vitamini seviyeleri sağlıklı kontrollere göre anlamlı olarak daha düşüktü (sırasıyla p=0,028, p=0,014). Nötrofil lenfosit oranı (NLO), birincil baş ağrısı grubunda anlamlı olarak daha yüksekti (p=0,033). Lojistik regresyon analizi, düşük ferritin seviyelerinin birincil baş ağrıları için bağımsız bir risk faktörü olduğunu göstermiştir (olasılık oranı =1,018, %95 güven aralığı =1,003-1,032). Sonuç: Bu çalışmada birincil baş ağrısı olan çocuklarda sağlıklı çocuklara göre serum vitamin B12 ve ferritin düzeyleri daha düşük, NLO daha yüksek olarak bulunmuştur. Bu sonucun daha fazla sayıda hastayı içeren prospektif çalışmalarla desteklenmesi gerektiğini düşünmekteyiz.

Neutrophil-lymphocyte Ratio and Serum Ferritin, Folate, Vitamin B12 and 25-hydroxyvitamin D Levels in Children and Adolescents with Primary Headaches

Objective: Headache is one of the most common complaints in general pediatricoutpatient clinics. We aimed to investigate the complete blood count (CBC)parameters and serum levels of 25-hydroxyvitamin D [25(OH)D], ferritin, vitaminB12 and folic acid in children and adolescents with primary headaches.Materials and Methods: In this study, 149 patients with primary headache[migraine, tension-type headaches (TTH) and unclassified headache] and 104 healthycontrols, aged 5 to 18 years, were evaluated retrospectively. Age, gender, physicalexamination findings and laboratory parameters [CBC, 25(OH)D, vitamin B12, folicacid and ferritin] were also recorded for both groups.Results: The headache types in the primary headache group were TTH (48.1%),migraine (28.2%) and unclassified headache (23.7%). The primary headache grouphad lower median levels of ferritin and serum vitamin B12 than healthy controls(p=0.028 and p=0.014, respectively). The neutrophil-lymphocyte ratio (NLR) wassignificantly higher in the primary headache group (p=0.033). A binary logisticregression analysis model showed low ferritin levels as an independent risk factorfor primary headaches (odds ratio =1.018, 95% confidence interval =1.003-1.032).Conclusion: The study results demonstrated lower serum vitamin B12 and ferritinand a higher NLR in children with primary headaches when compared to healthychildren. We suggest that these findings require support from larger prospectivestudies.

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