Work

Association of systemic inflammation indices with micronutrient status in adult patients with celiac disease

Year: 2026

Type: article

Abstract: Background Celiac disease is a chronic immune-mediated enteropathy associated with micronutrient deficiencies and persistent inflammation. Systemic inflammation indices derived from complete blood count parameters may reflect systemic inflammatory activity, but their relationship with micronutrient status in adult celiac disease remains unclear. We evaluated the association between systemic inflammation indices and micronutrient status in adults with celiac disease. Materials and methods This retrospective cross-sectional study included 120 adults with celiac disease followed at a tertiary center between January 2020 and October 2023. Systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were evaluated according to ferritin, transferrin saturation, vitamin B12, folate, and vitamin D status. Multiple comparisons were adjusted using the Holm method, and Firth penalized logistic regression was used for multivariable analyses of ferritin and vitamin B12 deficiency. Results Patients with ferritin deficiency had higher SII, NLR, and PLR values, and all associations remained significant after Holm correction. Higher SII and NLR were observed in patients with low transferrin saturation and vitamin B12 deficiency in unadjusted analyses, but these associations did not remain significant after Holm correction. In Firth penalized logistic regression, higher SII was associated with ferritin deficiency (adjusted OR per doubling of SII, 2.12; 95% CI, 1.31–3.58; p = 0.002). The association with vitamin B12 deficiency was considered exploratory because of the limited number of events. No associations were detected for folate or vitamin D deficiency. Conclusion Higher systemic inflammation indices, particularly SII, were associated with reduced iron stores in adults with celiac disease, with the association between SII and ferritin deficiency persisting after multivariable adjustment. Associations with transferrin saturation and vitamin B12 did not remain significant after correction for multiple comparisons and should be interpreted cautiously. These findings support further investigation of the relationship between systemic inflammation and micronutrient status in larger prospective cohorts.

Source: Frontiers in Medicine

DOI: 10.3389/fmed.2026.1898592