Hidden threat in familial Mediterranean fever: subclinical inflammation, oxidative stress and their relationship with vitamin D status

Abstract

Background/aim: Vitamin D levels have been investigated in children with familial Mediterranean fever (FMF), but the relationship between vitamin D status and inflammation/oxidative stress indicators could not be clearly demonstrated. This study aimed to investigate the relationship between subclinical inflammation/oxidative stress and vitamin D status in children with FMF during an attack-free period. Materials and methods:In the cross-sectional study, ninety children with FMF in the attack-free period and 30 healthy children were included in the study. Patients were grouped according to their vitamin D status (<20, 20-29, and 30-100 ng/mL). The groups were compared in terms of pentraxin 3 (PTX-3), total oxidant status (TOS), and total antioxidant status (TAS). Multivariable linear regression analysis was performed to identify factors associated with vitamin D status.Results: PTX-3 levels were significantly higher in patients with vitamin D insufficiency (20-29 ng/mL) than in the group with vitamin D sufficient (30-100 ng/mL). Patients with vitamin D deficiency (< 20 ng/mL) had higher TOS. A strong negative correlation was observed between vitamin D levels and TOS (p = 0.003). Subclinical inflammation (PTX-3 ≥0.640) and high TOS levels were negatively associated with vitamin D levels. Conclusion:Subclinical inflammation and oxidative stress were negatively associated with vitamin D levels in patients with FMF during an attack-free period. Sufficient vitamin D levels are important in fighting subclinical inflammation and oxidative stress in children with FMF.

Serum Vitamin D Levels In Pediatric Patients With Familial Mediterranean Fever

“…Several studies have elucidated the correlation between serum vitamin D levels and disease activity in pediatric FMF patients [6][7][8]. These studies often employ the measurement of 25-hydroxyvitamin D [25(OH)D], the primary circulating form of vitamin D, to assess vitamin D status.…”

“…These studies often employ the measurement of 25-hydroxyvitamin D [25(OH)D], the primary circulating form of vitamin D, to assess vitamin D status. It has been observed that pediatric patients with active FMF tend to have significantly lower levels of 25(OH)D compared to those in remission and healthy controls [8,9]. This deficiency may be linked to the pro-inflammatory state of FMF, as vitamin D is known to exert antiinflammatory effects through the inhibition of proinflammatory cytokines such as IL-1, IL-6, and TNF-α [8,10].…”