Evaluation of Serum 25(OH) Vitamin D as a Risk Factor in Adult Recurrent Tonsillitis

Abstract

BackgroundStudies have reported that the rate of upper respiratory tract infections in children and adults is inversely related to serum vitamin D levels and supplementation with vitamin D reduces the incidence of this infection. This study aimed to examine if vitamin D serum levels were a risk factor for recurrent tonsillitis among adult patients. MethodsRetrospective comparative analysis was carried out on 100 patients diagnosed with recurrent tonsillitis with 100 age-and sex-matched individuals as controls between June 2016 and May 2022. Tonsillar size was assessed based on Brodsky grading system. Serum levels of 25-hydroxy (25(OH)) vitamin D, total calcium, iron, hemoglobin, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were analyzed. ResultsThere was a statistically significant low vitamin D levels in tonsil size grades III+IV compared to grade I+II (p <0.001) among cases. There was a significantly lower serum value for 25(OH) vitamin D in the cases as compared to the control group (p <0.001). A high percentage (68%) of cases had vitamin D deficiency (<20 ng/mL) and this was statistically significant (p <0.001). There were statistically significant higher values of CRP and ESR among cases compared to the control group (p <0.001). At a cut off (≤21.2), serum vitamin D levels achieved 78% sensitivity, 65% specificity (p <0.001) to differentiate cases from controls. Following logistic regression analysis, the level of vitamin D was the only significant risk factor. ConclusionFindings from our study also suggest an association between recurrent tonsillitis among our adult cohorts and low serum 25(OH) vitamin D levels. Therefore, we opine that serum vitamin D levels should be considered in the management of adult patients with tonsillitis.

Is There any Association between Vitamin D Deficiency and Recurrent Tonsillopharyngitis? An Updated Systematic Review

“…Lastly, Elbistanli et al (8) correlated lower 25-hydroxyvitamin D levels with larger tonsil size (p = 0.023). Conversely, Hussein et al (45) did not identify a significant relationship between serum 25-hydroxyvitamin D and tonsil size. Now, the question that remains is whether vitamin D supplementation could decrease the incidence of URTIs.…”

“…In a retrospective comparative analysis, Hussein et al (45) examined whether serum 25-hydroxyvitamin D levels were a risk factor for recurrent TPS among adult patients. Thus, 100 adult patients with recurrent TPS were recruited as cases, while the control group comprised 100 subjects with no prior history of recurrent TPS.…”

“…Eleven studies with a total of 2 503 participants, which had been conducted in various countries globally, were included in the present systematic review. Four studies were carried out in Turkey (8,17,19,39), two in India (40,41), one in Israel (9), one in Italy (42), one in Iraq (43), one in Jordan (44) and one in Saudi Arabia (45). Both pediatric and adult patients were assessed.…”

Impact of Low-Temperature Plasma Radiofrequency Tonsillectomy on Pain, Inflammatory Markers, and Sleep Quality in Adults with Chronic Tonsillitis

“…hs-CRP is a sensitive, improved form of CRP synthesized mainly in the liver. In chronic inflammatory states, especially in bacterial infections, hs-CRP levels increase [28]. In CT, continuous inflammatory stimulation may lead to persistent hs-CRP production.…”