This is the case of Vitamin D Deficiency and Its Relationship with Inflammatory Markers, Immune Function, and Hematological Parameters in Adults of Iraq

Abstract

Background: Deficiency of vitamin D is very high among the populations in middle east although there is ample sunshine with new findings that it is connected to immune dysfunction as well as chronic inflammation. The correlation of the state of vitamin D with inflammatory parameters and immune parameters is critical to interventions to improve the health of the population. Purpose: The aim of the study was to calculate the level of vitamin D deficiency among the population of Iraqi adults and to identify its correlation with the level of inflammatory markers (IL-6, TNF-a, hs-CRP), with immune parameters (lymphocyte subsets, immunoglobulins) and hematological indicators. Methods: It was a cross-sectional study that involved 250 apparently healthy Iraqi adults (18-60 years). The vitamin D status of the participants was stratified: deficient (Less than 20 ng/ml, n=118), insufficient (20-29 ng/ml, n=82), and sufficient ([?]30 ng/ml, n=50). Serum 25 (OH) D, inflammatory markers, lymphocyte subsets (flow cytometry), immunoglobulins and complete blood count were measured. Findings: Prevalence of vitamin D deficiency was 47.2 with insufficiency level of 32.8. Insufficient subjects had much higher levels of inflammatory markers than deficient: IL-6 (12.8+-3.4 vs 4.6+-2.1 pg/mL, P<0.001), TNF-a (18.6+-4.2 vs 8.2+-2.1 pg/mL, P<0.001), hs-CRP (4.8+-1.4 vs 1.4+-0.4 mg/L, P<0.001). There was a decrease in CD4+ T cells (32.4+-5.8% vs 41.2+-6.4%, P<0.001) and CD4/CD8 ratio (1.86 to 1.24). Deficient subjects had an increased neutrophil-to-lymphocyte ratio (NLR) (2.86+-0.64 vs 1.68+-0.38, P<0.001). There were strong negative correlations between 25(OH)D and IL-6 (r=[?]0.68) and NLR (r=[?]0.62). Conclusion: Vitamin D deficiency is very common in the Iraqi adult population and is correlated with high levels of inflammatory markers, poor cellular immunity and high NLR. These results justify the relevance of vitamin D screening and supplementation interventions in the population.