Serum Levels of IL-6, IL-10, TNF-α, and Vitamin D: Their Correlation with Acute Otitis Media in Short-Stature Pediatric Patients

Arif Dermawan,1 Bejo Ropii,2 Lina Lasminingrum,1 Wijana Hasansulama,1 Budi Setiabudiawan3,4 1Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung, Bandung, 40161, Indonesia; 2Departemen of Biomedical Engineering, Preanger Institute for Biomedical Engineering, Science, and Technology, Bandung, Indonesia; 3Department of Child Health, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, 40161, Indonesia; 4Faculty of Medicine President University, Cikarang, Bekasi, 17550, IndonesiaCorrespondence: Arif Dermawan, Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung, Bandung, 40161, Indonesia, Email [email protected]: Short stature in children is a global health issue often linked to micronutrient deficiencies like vitamin D, potentially impairing immune function. Acute Otitis Media (AOM) is a common complication of upper respiratory infections in children, with inflammatory cytokines such as IL-6, IL-10, and TNF-α playing a crucial role in its pathogenesis. This study aims to explore the correlation between serum levels of these biomarkers and AOM occurrence in short-stature pediatric patients.Purpose: To assess the relationship between serum levels of IL-6, IL-10, TNF-α, and vitamin D and their association with AOM in children with short stature.Patients and Methods: A case-control study was conducted with 180 children aged 24– 59 months, divided into four groups: short stature with AOM, short stature without AOM, normal stature with AOM, and normal stature without AOM. Serum levels of IL-6, IL-10, TNF-α, and vitamin D were measured using the ELISA method. The data were analyzed using descriptive, bivariate, and multivariate statistical methods.Results: Children with short stature and AOM had the highest median levels of IL-6 (12.15 pg/mL) and TNF-α (162.52 pg/mL), while IL-10 levels were lowest in this group (0.56 pg/mL), indicating a robust inflammatory response associated with AOM. Multivariate analysis revealed that male sex, vitamin D levels ≤ 18.9 ng/mL, IL-6 levels > 9.42 pg/mL, and IL-10 levels ≤ 0.76 pg/mL were significant risk factors for developing AOM, with respective odds ratios indicating markedly elevated risks.Conclusion: This study underscores the significant role of inflammatory markers and vitamin D deficiency in the development of AOM in short-stature pediatric patients. Regular monitoring and targeted interventions may help prevent AOM in this vulnerable population, warranting future research on the effectiveness of vitamin D supplementation and other therapeutic strategies.Keywords: acute otitis media, AOM, IL-6, TNF-α, inflammatory cytokines, short stature, vitamin D deficiency