ISSN : 2663-2187

Elevated White Blood Cell Subsets and Imbalances in Iron, Magnesium, and Vitamin D3 Are Linked To Severity of Pediatric Asthma

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Shivani Singh, Manish Raj Kulshrestha, Aditi Singh, Shetanshu Srivastava, Vandana Tiwari
» doi: 10.33472/AFJBS.6.14.2024.7854-7864

Abstract

Background: The diagnosis of asthma is dependent on the clinical presentation of bronchospasm, spirometry results, altered white blood cells, allergic variables, essential minerals (cofactors of enzymes), and VitaminD3. Aim: This study is aimed to evaluate the hematological parameters and allergy markers. In addition, we studied the effect of essential elements and Vitamin D3 on asthma. Method: In this study, 48 children diagnosed with asthma at the OPD of asthma clinic, Dr. RMLIMS, Lucknow, and 19 non-asthmatic controls age-sex-matched were enrolled. The hematological parameters were estimated by SysmexXT2000i. Calcium, Magnesium, Phosphorus, Iron, IgE, and hs-CRP were estimated by Beckman Coulter (AU480) automated analyzer and Vitamin D3 was analyzed by the immunochemilumine scent method. Result: There were no significant differences in age and sex in asthma and the control group showed adequate matching (p=0.743 and p=0.462 respectively); however, FEV1% [asthmatic case: median, 75.8 (Q157.2- Q387.5)] vs [control: median, 95 (Q1:79.2- Q3: 89.5) was significantly associated with asthma (p<0.00001). The study revealed significant differences between asthmatic children and a control group. Asthmatic children had higher levels of leukocyte counts ((Median;9.01 ×103/µL, p<0.0001), neutrophil counts (Median: 54.5%, p<0.0001), lymphocyte counts (Median: 38.50%, p<0.0001), eosinophil counts (Median: 9.50%, p<0.0001). The IgE (median: 996.85IU/mL; Q1:331.06-Q3:1676.3 vs median: 57.32IU/mL; Q1:49.09- Q3:71.29) and hs-CRP (median: 3.10 mg/L; Q1:0.90- Q3:6.59 vs median: 0.81 mg/L; Q1:0.75- Q3:0.92) were significantly elevated in asthmatic cases as compared to control (p<0.05). However, iron, magnesium, and vitamin D3 were significantly lower in asthmatic cases than the control (p<0.0001). The univariate and multivariate regression analyses showed that iron (univariate: β=0.132, p=0.041; multivariate: β=0.112, p=0.049) and magnesium (univariate: β = 0.133, p=0.043; multivariate: β=0.114, p=0.048) showed a positive association with the FEV1/FVC ratio. Conversely, vitamin D3 was negatively associated (univariate: β=-0.165, p=0.012; multivariate: β =- 0.156, p=0.018). Conclusions: Rise in WBCs subsets with IgE and hs-CRP in asthmatic children was observed. Essential elements and Vitamin D3 association indicate it may as a confounder of asthmatic components. Parental smoking, family history, and atopy are risk modifiers for asthma.

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