Association between vitamin D serum levels and inflammatory markers in patients on hemodialysis

Gac Med Mex. 2020;156(6):509-515. doi: 10.24875/GMM.M21000452.

Abstract

Introduction: The relationship between 25-OH-vitamin D and the immune system in patients with chronic kidney disease is a subject of attention.

Objectives: To assess the prevalence of vitamin D deficiency in patients on hemodialysis and to investigate the association between vitamin D, ultra-sensitive C-reactive protein (US-CRP), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR).

Method: Cross-sectional study of 80 patients on hemodialysis, divided into two groups: a serum 25-OH-vitamin D level < 20 ng/mL was considered to be vitamin D deficiency and a serum level ≥ 20 ng/mL was regarded as normal. The relationship between the parameters was defined with Spearman's correlation analysis.

Results: 40 % of the patients had vitamin D deficiency. There were significant differences between groups in US-CRP (p = 0.047), NLR (p = 0.039), PLR (p = 0.042) and treatment with vitamin D analogues (p = 0.022). Vitamin D had a significant negative correlation with US-CRP (p = 0.026), NLR (p = 0.013) and PLR (p = 0.022).

Conclusions: The prevalence of vitamin D deficiency was 40 %. The values of US-CRP, NLR and PLR were significantly higher in the presence of vitamin D deficiency. A significant inverse correlation was found between vitamin D levels and US-CRP, NLR and PLR.

Introducción: La relación entre 25-OH-vitamina D y el sistema inmune en pacientes con enfermedad renal crónica es objeto de atención.

Objetivos: Evaluar la prevalencia de la deficiencia de vitamina D en pacientes en hemodiálisis e investigar la asociación entre la vitamina D y proteína C reactiva ultrasensible (PCRus), índice neutrófilo-linfocito (INL) e índice plaqueta-linfocito (IPL).

Método: Estudio transversal de 80 pacientes en hemodiálisis, divididos en dos grupos: un nivel sérico de 25-OH-vitamina D < 20 ng/mL se consideró como deficiencia de vitamina D y ≥ 20 ng/mL, como normal. Con el análisis de correlación de Spearman se definió la relación entre los parámetros.

Resultados: 40 % de los pacientes presentó deficiencia de vitamina D. Hubo diferencias significativas entre los grupos en PCRus (p = 0.047), INL (p = 0.039), IPL (p = 0.042) y tratamiento con análogos de vitamina D (p = 0.022). La vitamina D tuvo una correlación negativa significativa con PCRus (p = 0.026), INL (p = 0.013) e IPL (p = 0.022).

Conclusiones: La deficiencia de vitamina D fue de 40 %. Los niveles de PCRus, INL e IPL fueron significativamente más altos ante deficiencia de vitamina D. Se encontró correlación inversa significativa entre vitamina D y PCRus, INL e IPL.

Keywords: Deficiencia de vitamina D; Neutrophil-to-lymphocyte ratio; Platelet-to-lymphocyte ratio; Proteína C reactiva ultrasensible; Ultra-sensitive C-reactive protein; Vitamin D deficiency; Índice neutrófilo-linfocito; Índice plaqueta-linfocito.

MeSH terms

  • Aged
  • Biomarkers / blood
  • Blood Platelets / cytology
  • C-Reactive Protein / analysis
  • Cross-Sectional Studies
  • Female
  • Humans
  • Inflammation Mediators / blood*
  • Lymphocytes / cytology
  • Male
  • Neutrophils / cytology
  • Prevalence
  • Renal Dialysis*
  • Renal Insufficiency, Chronic / blood*
  • Renal Insufficiency, Chronic / therapy
  • Vitamin D / blood*
  • Vitamin D Deficiency / blood*
  • Vitamin D Deficiency / epidemiology*

Substances

  • Biomarkers
  • Inflammation Mediators
  • Vitamin D
  • C-Reactive Protein