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Impact of vitamin D deficiency upon clinical presentation in nasal polyposis

Authors

  • Rodney J. Schlosser MD,

    Corresponding author
    1. Department of Surgery, Ralph H. Johnson VA Medical Center, Charleston, SC
    2. Division of Rhinology & Sinus Surgery, Department of Otolaryngology, Medical University of South Carolina, Charleston, SC
    • Correspondence to: Rodney J. Schlosser, MD, Division of Rhinology & Sinus Surgery, Department of Otolaryngology, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425; schlossr@musc.edu

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  • Zachary M. Soler MD,

    1. Division of Rhinology & Sinus Surgery, Department of Otolaryngology, Medical University of South Carolina, Charleston, SC
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  • Gregg W. Schmedes MD,

    1. Division of Rhinology & Sinus Surgery, Department of Otolaryngology, Medical University of South Carolina, Charleston, SC
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  • Kristina Storck MSPH,

    1. Division of Rhinology & Sinus Surgery, Department of Otolaryngology, Medical University of South Carolina, Charleston, SC
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  • Jennifer K. Mulligan PhD

    1. Department of Surgery, Ralph H. Johnson VA Medical Center, Charleston, SC
    2. Division of Rhinology & Sinus Surgery, Department of Otolaryngology, Medical University of South Carolina, Charleston, SC
    3. Department of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC
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  • Funding sources for the study: Flight Attendant Medical Research Institute and VA Merit grants (both to R.J.S.).

  • Potential conflict of interest: None provided.

Abstract

Background

The objective of this work was to determine if specific chronic rhinosinusitis with nasal polyps (CRSwNP) populations are at risk for vitamin D3 (VD3) deficiency and if VD3 levels correlate with radiographic measures of disease severity or eosinophilia.

Methods

This study was a retrospective review of an academic rhinology practice. CRSwNP patients who had VD3 levels and CT scan within 6 months of each other were included. CT scans were graded using Lund-Mackay scoring (LMS) and peripheral eosinophil counts were measured. Demographic data including race, gender, age, body mass index, atopic status, and presence of asthma were collected. CRSwNP was subdivided into allergic fungal rhinosinusitis (AFRS), aspirin-exacerbated respiratory disease (AERD), and other CRSwNP. Multivariate analysis was performed to examine correlations and control for confounding factors.

Results

Insufficient VD3 levels were found in 55% of all CRSwNP patients. VD3 correlated with African American race because nearly 80% of all African Americans had insufficient VD3 levels. Lower VD3 levels also correlated with more severe mucosal disease on CT scans as measured by LMS. There was no correlation between VD3 levels and age, gender, body mass index, atopy, asthma, or CRSwNP subtype.

Conclusion

VD3 insufficiency/deficiency is common in CRSwNP patients, especially those of African American race. Lower levels of VD3 are associated with worse LMS on CT. The role of VD3 in CRSwNP warrants further investigation.

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