D Vitamini Düzeyleri ile İnflamasyon Belirteçleri Arasındaki İlişkinin Değerlendirilmesi

25-hidroksivitamin D (25(OH)D) düzeyleri ile inflamasyon belirteçleri olan C-reaktif protein (CRP), eritrosit sedimantasyon hızı (ESR), lökosit sayısı ve nötrofil/lenfosit (N/L) oranı parametreleri arasındaki ilişkinin incelenmesi amaçlandı. Ek olarak, D vitamini eksikliği olan popülasyondaki inflamasyon belirteçlerinin yüksekliğinin ve eş zamanlı olarak inflamasyon belirteçleri yüksek olan popülasyondaki D vitamini eksikliğinin araştırılması amaçlandı. Eylül 2017 – Mart 2020 tarihleri arasında 18 yaş ve üzerindeki 49166 erişkin hastaya ait eş zamanlı olarak istenmiş olan 25(OH)D, CRP, ESR, lökosit sayısı ve N/L oranı sonuçları retrospektif olarak incelendi. Parameteler arasındaki korelasyonlar ve 25(OH)D eksikliği ve inflamasyon belirteçleri yükseklikleri arasındaki ilişkiler değerlendirildi. İnflamasyon belirteçleri olan CRP, ESR, lökosit sayısı ve NLR ile 25(OH)D arasında zayıf düzeyde ters yönlü korelasyonlar tespit edildi (sırasıyla; r=-0,077, p<0.01; r=-0,036, p<0.01; r=-0,074, p<0.01 ve r=-0,074, p<0.01). D vitamini eksiklik sınır değeri olarak 30 ng/mL kabul edildiğinde, 25(OH)D eksikliği olanların %63,2’sinde CRP düzeyleri normal iken, CRP yüksekliği olanların %85,6’sında 25(OH)D eksikliği olduğu saptandı (p<0,001). Benzer olarak 25(OH)D eksikliği olanların %85,3’ünde lökosit sayısı normal iken, lökosit yüksekliği olanların %86,6’sında 25(OH)D eksikliği olduğu saptandı (p<0,001). Ek olarak, 25(OH)D eksikliği olanların %42,7’sinde ESR düzeyleri normal iken, ESR yüksekliği olanların %84,1’inde 25(OH)D eksikliği olduğu saptandı (p<0,001). Çalışmanın bulguları, D vitamini düşüklüğünün inflamasyona neden olmasından ziyade D vitamini düzeylerinin inflamasyonun sonucu olarak düşük olduğu hipotezini desteklemektedir.

Anahtar Kelimeler:

D vitamini, inflamasyon, inflamasyon belirteçleri, C-reaktif protein

Evaluation of the Relationship Between Vitamin D Levels and Inflammation Markers

The aim of this study was to investigate the relationships between 25-hydroxyvitamin D (25(OH)D) levels and inflammation markers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), leukocyte count and neutrophil/lymphocyte (N/L) ratio parameters. In addition, it was aimed to investigate the frequency of elevation of inflammation markers in vitamin D deficient population and thus frequency of vitamin D deficiency in the population with elevated inflammation markers. Simultaneously requested 25(OH)D, CRP, ESR, leukocyte count and N/L ratio results of 49166 adult patients between September 2017 and March 2020 were retrospectively analyzed. The correlations between parameters and the frequencies of 25(OH)D deficiency and elevated inflammation markers were evaluated. Weak inverse correlations were observed between 25(OH)D and inflammation markers such as CRP, ESR, leukocyte count and NLR (r=-0.077, p<0.01; r=-0.036, p<0.01; r=-0.074, p<0.01 and r=-0.074, p<0.01, respectively). When <30 ng/mL considered as the cut-off value for vitamin D deficiency; CRP levels were normal in 63.2% of those with 25(OH)D deficiency, while 85.6% of those with elevated CRP levels had 25(OH)D deficiency (p<0.001). Similarly, while the leukocyte count was normal in 85.3% of those with 25(OH)D deficiency, 86.6% of those with elevated leukocyte deficiency had 25(OH)D deficiency (p<0.001). In addition, while ESR levels were normal in 42.7% of those with 25 (OH) D deficiency, it was found that 84.1% of those with elevated ESR had 25(OH)D deficiency (p<0.001). The findings of this study support the hypothesis that vitamin D levels are low as a result of inflammation rather than the lower vitamin D levels causes inflammation.

Keywords:

vitamin D, inflammation, inflammation markers, C-reactive protein,

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