We investigated vitamin D deficiency in pediatric sickle cell disease patients and its association with selected bone, lipid and inflammatory parameters. The study included 64 patients (33 SS and 31 SB) and 21 carriers (AS). Blood was obtained to assess levels of vitamin D, WBC, CRP, Ca, P, ALP, PTH, triglyceride, total cholesterol, LDL, VLDL, HDL, IL-2, IL-12, TNF-α, IL-4, IL-6, IL-10 and regulatory T cells. The patients were grouped according to their genotype (SS, SB) and vitamin D status (low or normal). Carriers were also grouped as low or normal vitamin D. Laboratory findings were similar between low and normal Vit D groups in SS, SB and AS genotypes except a lower IL-12 in SB-low vitamin D compared SB-normal vitamin D group. Acute chest syndrome was more frequent in SS-low Vit D (63%) compared to SS-normal Vit D (25%), SB-low Vit D (21%) and SB-normal Vit D (33%) (P = 0.045). Both SS and SB with low vitamin D had higher VLDL (P = 0.006 and P = 0.022), TNF-α (P = 0.001) and regulatory T cells (P = 0.000) compared to AS-low vitamin D. Both SS and SB with normal vitamin D had higher levels of regulatory T cells (P = 0.000) compared to AS-normal vitamin D. Vit D was not a modifier of selected inflammation, bone and lipid parameters in sickle cell disease. Acute chest syndrome was comparably more frequent in SS-low vitamin D. Increase of regulatory T cells in the patients was a result of chronic inflammation in sickle cell disease.
Sickle cell disease Genotype Vitamin D Cytokine TNF-α Regulatory T cell Lipid VLDL
This is a preview of subscription content, log in to check access.
This study was funded by a grant from Turkish Scientific Research and Technical Council (112S243).
Compliance with Ethical Standards
Conflict of interest
Authors YO, SU, GE, LT and NO declare that they have no conflict of interest.
Research Involving Human Participants and/or Animals
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual children and their parents.
Rovner AJ, Stallings VA, Kawchak DA et al (2008) High risk of vitamin D deficiency in children with sickle cell disease. J Am Diet Assoc 108(9):1512–1516CrossRefPubMedGoogle Scholar
Van Belle TL, Gysemans C, Mathieu C (2011) Vitamin D in autoimmune, infectious and allergic diseases: a vital player? Best Pract Res Clin Endocrinol Metab 25(4):617–632CrossRefPubMedGoogle Scholar
Chen S, Sims GP, Chen XX et al (2007) Modulatory effects of 1,25-dihydroxyvitamin D3 on human B cell differentiation. J Immunol 179(3):1634–1647CrossRefPubMedGoogle Scholar
Adegoke SA, Smith OS, Adekile AD et al (2017) Relationship between serum 25-hydroxyvitamin D and inflammatory cytokines in paediatric sickle cell disease. Cytokine 96:87–93CrossRefPubMedGoogle Scholar
Oztas Y, Durukan I, Unal S et al (2011) Plasma protein oxidation is correlated positively with plasma iron levels and negatively with hemolysate zinc levels in sickle-cell anemia patients. Int J Lab Hematol 34(2):129–135CrossRefPubMedGoogle Scholar
Zorca S, Freeman L, Hildesheim M et al (2010) Lipid levels in sickle-cell disease associated with haemolytic severity, vascular dysfunction and pulmonary hypertension. Br J Haematol 149(3):436–445CrossRefPubMedPubMedCentralGoogle Scholar
Rodriguez-Rodriguez E, Perea JM, Jimenez AI et al (2010) Fat intake and asthma in Spanish schoolchildren. Eur J Clin Nutr 64(10):1065–1071CrossRefPubMedGoogle Scholar
Binkley N, Ramamurthy R, Krueger D (2012) Low vitamin D status: definition, prevalence, consequences, and correction. Rheum Dis Clin N Am 38(1):45–59CrossRefGoogle Scholar
Jorde R, Grimnes G (2011) Vitamin D and metabolic health with special reference to the effect of vitamin D on serum lipids. Prog Lipid Res 50(4):303–312CrossRefPubMedGoogle Scholar
Muldoon MF, Marsland A, Flory JD et al (1997) Immune system differences in men with hypo- or hypercholesterolemia. Clin Immunol Immunopathol 84(2):145–149CrossRefPubMedGoogle Scholar
Rego MJ, da Silva RR, Pereira MC et al (2015) Evaluation of CD4(+)CD25(+)FoxP3(+) T cell populations, IL-10 production, and their correlation with clinical and biochemical parameters in sickle cell anemia patients with leg ulcers. Cytokine 75(2):310–315CrossRefPubMedGoogle Scholar
Lee MT, Licursi M, McMahon DJ (2015) Vitamin D deficiency and acute vaso-occlusive complications in children with sickle cell disease. Pediatr Blood Cancer 62(4):643–647CrossRefPubMedGoogle Scholar