Photo Credit: Helin Loik-Tomson

Low vitamin D in patients with nasal polyps negatively correlated with several markers, including Lund-Mackay and total nasal polyp scores.

“Recently, the role of vitamin D in the development of allergic diseases, including [chronic rhinosinusitis with nasal polyposis (CRSwNP)], has attracted considerable attention,” researchers wrote in Ear, Nose & Throat Journal. “Vitamin D has been shown to have immunomodulatory effects and is essential for the control of several immune cells, including T cells and dendritic cells, as well as reducing inflammation through multiple mechanisms.”

Research indicates that vitamin D impacts the innate and adaptive immune systems and structural cells in the respiratory tract. Additionally, inadequate levels of vitamin D can increase inflammation, whereas supplementation can decrease these inflammatory effects.

Ahmad Alroqi, MD, and colleagues examined the relationship between serum vitamin D levels and the severity of CRSwNP in patients with uncontrolled CRSwNP who failed maximum medical management and had functional endoscopic sinus surgery scheduled. They compared vitamin D levels between patients using the Lund-Mackay (LM) score, Sinonasal Outcome Test-22 (SNOT-22) scores, total nasal polyp scores, and absolute eosinophil counts.

Vitamin D Deficiency Seen in Nearly Half of Patients

The study included 104 patients (average age, 42.09±13.3; 63.5% men). Other relevant patient characteristics included:

• Mean vitamin D value (57.9±31.2 nmol/L)
• Average SNOT-22 score (65.49±21.3)
• Mean LM score (14.48±6.64)
• Total nasal polyp score (4.3±2.08)

Nearly half of the study participants (49.0%) had a vitamin D deficiency, defined as less than 50 nmol/L, according to the study results (Table).

The study team assessed correlations between serum vitamin D levels and various variables, such as the total nasal polyp score (r, −0.264; P=0.007) and the LM score (r, −0.210; P=0.032), and identified “a significant negative correlation.” However, significant correlations were not found between serum vitamin D levels and the SNOT-22 score, absolute eosinophil count, age, height, weight, or BMI.

“We found that low serum vitamin D levels were negatively correlated with the Lund-Mackay score and the total nasal polyp score, providing additional support for an association between low vitamin D levels and a greater severity of CRSwNP,” the researchers wrote.

Potential Use of Vitamin D Levels in Clinical Settings

Dr. Alroqi and colleagues acknowledged several limitations of their research, including the small sample size and the inclusion of only Middle Eastern patients. However, they pointed to previous research in larger, more diverse populations of patients that found a significant association between low serum vitamin D levels and the severity of CRSwNP.

They also outlined the strengths of the current study, including the correlation between low vitamin D levels and greater disease severity. This finding “indicates that serum vitamin D levels could be used as a supplementary biomarker for assessing the degree of CRSwNP, thus augmenting the value of current diagnostic tools, such as endoscopy and computed tomography scans,” they wrote.

Further, their findings and the results of prior studies suggest that vitamin D may be beneficial in treating nasal polyp-related. However, further research is needed, including randomized controlled trials and longitudinal studies.

“These preliminary findings point to the potential value of vitamin D assessment in the clinical evaluation and management of CRSwNP,” the researchers wrote. “However, further studies are required to completely clarify the nature of this association and to determine whether vitamin D supplements could successfully treat or improve the symptoms of CRSwNP.”