Vitamin D deficiency contributes to development of nasal polyps in Iraqi patients suffering from chronic rhinosinusitis

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Mohammed Saeed Abd Ali
Osama Awaad Ali


Vitamin D, nasal polyps, chronic rhinosinusitis


Chronic rhinosinusitis is a disease of the upper respiratory truck of unknown origin, characterized by chronic inflammation of the lining epithelium of nasal and paranasal air sinuses. There are two main phenotypes, chronic rhinosinusitis without polyps and chronic rhinosinusitis with polyps’ development. Several reports highlighted the importance of vitamin D in the pathogenesis of chronic rhinosinusitis.
Aim: To evaluate vitamin D levels between patients suffering from chronic rhinosinusitis and to explore the relationship between vitamin D deficiency and the severity of chronic rhinosinusitis through radiologic staging score. Also, to determine the role of vitamin D on the development of nasal polyps in Iraqi patients.
Methods: Sixty (60) patients with clinical signs and symptoms of chronic rhinosinusitis were recruited at ENT units of Al-Diwaniyah and Al-Kut teaching hospitals in Iraq. Selected individuals were subjected to nasal endoscopy and CT radiographic imaging to assess severity and nasal polyps’ formation. Serum samples were also collected to evaluate vitamin D concentration by utilizing quantitative immunofluorescent technique.
Results: Serum levels of vitamin D were significantly lower in patients suffering from chronic rhinosinusitis with polyps compared to those who did not present nasal polyps, mean concentration being (17.9±5.9) ng/ml, and (27.3±7.5) ng/ml, respectively, (P<0.001). Correlative analysis and odd ratio estimation presented significant association between vitamin D and nasal polyps’ formation (r=-0.578, P<0.001, odd ratio= 51.6%, 95% CL (-11.504 to -4.626). The severity of chronic rhinosinusitis also showed negative correlation with levels of vitamin D, (r=-0.431, P=0.026, odd ratio=14.3%). Furthermore, estimated best cutoff values of vitamin D that can predicts nasal polyps’ development in patients with chronic rhinosinusitis was found at 19.95 ng/ml.
Conclusion: Patients suffering from chronic rhinosinusitis and polyp growth showed low vitamin D levels compared to those without nasal polyps. Vitamin D deficiency correlated significantly with severity of chronic rhinosinusitis and nasal polyps’ formation. The estimated vitamin D cutoff values by the current study could potentially be applied to evaluate the severity of the condition and the risk of nasal polyp growth.

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