Abstract: Objective  To investigate the relationship between serum 25-hydroxyvitamin D (25(OH)D) level and novel inflammatory markers in maintenance hemodialysis (MHD) patients.   Methods  A total of 153 MHD patients were enrolled in this study. Patients were divided into three groups according to the serum 25(OH)D level: 25(OH)D deficiency group (serum 25(OH)D＜20ng/ml, n=50), 25(OH)D insufficiency group (serum 25(OH)D 20～30ng/ml, n=57), and 25(OH)D normal group (serum 25(OH)D >30ng/ml, n=46). The neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), monocyte to high-density lipoprotein cholesterol ratio (MHR) and C-reactive protein to albumin ratio (CAR) were calculated. Spearman correlation analysis and linear regression analysis were used to define differences of the parameters among groups.  Results The three groups showed statistical differences of age (F=4.061, P=0.019), diabetes (c2=6.982, P=0.030), diastolic blood pressure (F=3.200, P=0.044), serum albumin (F=8.744, P＜0.001), serum creatinine (F=3.844, P=0.024), total cholesterol (F=3.392, P=0.036), low-density lipoprotein cholesterol (F=3.296, P=0.040), NLR (F=5.633, P=0.004), MLR (F=7.569, P=0.001) and MHR (F=4.568, P=0.012). Serum 25(OH)D level was negatively correlated with age (r=−0.261, P=0.001), NLR (r=−0.261, P=0.001), MLR (r=−0.302, P<0.001), MHR (r=−0.256, P=0.002) and CAR (r=−0.179, P=0.029), and was positively correlated with diastolic blood pressure (r=0.227, P=0.005), albumin (r=0.207, P＜0.001), creatinine (r=0.288, P＜0.001), calcium (r=0.161, P=0.048), phosphorus (r=0.164, P=0.044), total cholesterol (r=0.241, P=0.004) and low-density lipoprotein cholesterol (r=0.241, P=0.004). Multivariate linear regression revealed that male gender (β=3.445, P=0.033), diabetes (β=-4.233, P=0.014), diastolic blood pressure (β=0.158, P=0.013), albumin (β=0.584, P=0.013), NLR (β=-1.351, P=0.001) and MHR (β=-6.894, P=0.032) were independently associated with serum 25(OH)D level.  Conclusions Serum 25(OH)D level is negatively correlated with NLR, MLR, MHR and CAR, in which NLR and MHR are independently correlated with serum 25(OH)D levels. Serum 25(OH)D level is closely related to the inflammatory status in MHD patients.

Key words: Hemodialysis, 25-hydroxyvitamin D, Inflammatory marker