Level of Vitamin D, TNF-Alpha and Calcium in Patients with Dengue Fever, Dengue Hemorrhagic Fever and Dengue Shock Syndrome

Abstract

Background: Vitamin D has been widely studied for its beneficial role in treating different diseases. Dengue epidemic has affected many house hold since last decade. Vitamin D seems a gate through in its treatment as it inhibits Th1 cytokine activities, responsible for the development of dengue complications.Objective: To determine the levels of vitamin D, TNF- α and calcium in patients with variation of dengue fever stages.Methods: A cross sectional analytical study conducted on dengue confirmed patients (fever, hemorrhagic, shock) admitted in tertiary care hospitals of Lahore (IRBNo.1165). After obtaining informed consent the study objectives were explained to the patients and data collected. Patients were classified into three groups (a) dengue fever (DF) (b) dengue hemorrhagic fever(DHF) and (c) dengue shock syndrome (DSS) (40+30+10 cases). Serum from 5cc blood was stored at –20⁰ C until analysis. The data was analyzed using SPSS version 21.Results: The study was conducted in 4 hospitals of Lahore on 80 NS1confirmed cases (age: 5-70 years). The age difference, vitamin D and calcium levels were significant (p-values 0.030, 0.047 and 0.003 respectively). Calcium levels were lowest in DSS and significantly lower than DHF patients. Vitamin D levels were higher among those with higher severity of disease with p-value 0.031. The patients did not have significantly different TNF α levels. There were 90.0% of DSS cases that had TNF α levels > 100, (p-value 0.109).Conclusion: High levels of TNF-alpha are associated with dengue complications regardless of vitamin D levels and severity of disease.