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5X more likely to be vitamin D deficient if anemic - Dec 2012

Prevalence of 25-Hydroxyvitamin D Deficiency in Korean Patients with Anemia

Red Cells and Erythropoiesis, Structure and Function, Metabolism and Survival, Excluding Iron
Blood (ASH Annual Meeting Abstracts) 2012 120: Abstract 5164
© 2012 American Society of Hematology December 8-11, 2012; Georgia World Congress Center, Atlanta, GA
Eun-Hyung Yoo, MD* and Hyun-Jung Cho, MD, PhD*
Department of Laboratory Medicine, Konyang University Hospital, Daejon, South Korea

Background: Vitamin D deficiency is a very common health problem in Korea. Vitamin D has been suggested to have an important role on nonskeletal functions including cellular proliferation and differentiation, muscle function, immunity and erythropoiesis. Recent studies have been reported that vitamin D deficiency had associated with iron deficiency anemia, anemia of chronic kidney disease, and anemia of inflammation. In this study, we investigated the prevalence of vitamin D deficiency in Korean patients with anemia and also analyzed the association between vitamin D status and specific subtypes of anemia.

Methods: A total of 147 anemic patients (median age 66 years, range 1991 years) and 300 nonanemic controls (median age 60 years, range 2987 years) were included. Anemia was defined according to World Health Organization (WHO) criteria. Serum 25- hydroxyvitamin D [25(OH)D] was measured using electrochemiluminescence immunoassay. The deficiency of 25(OH)D was defined as <20 ng/mL and severe deficiency was defined as <10 ng/mL. We compared serum 25(OH)D levels based on the presence and subtypes of anemia.

Results: The prevalence of 25(OH)D deficiency was 74% (109/147) and 70% (210/300) in anemic (median Hb 9. 6 g/dL) and nonanemic group (median Hb 14. 3 g/dL), respectively. The prevalence of severe 25(OH)D deficiency was significantly higher in anemic group than in nonanemic group [44. 8% (66/147) vs 11. 7% (35/300), P<0. 0001] Odds ratio for severe 25(OH)D deficiency in anemic patients was 6. 17 (95% CI 3. 820–9. 965, P<0. 0001). The prevalence of 25(OH)D deficiency was not different between iron deficiency anemia (IDA) group and anemia of chronic disease (ACD) group. However, the serum 25(OH)D levels of ACD patients were lower than those of IDA patients in male (median 25(OH)D 14. 34 ng/mL vs 23. 04 ng/mL, P=0. 04).

Conclusion: This study demonstrates that severe vitamin D deficiency is associated with anemia in Korea. Although vitamin D deficiency is also very common in nonanemic Korean population, anemia is related to much worse vitamin D deficient status. Multiple factors including poor nutritional status and potential roles of vitamin D on inflammation and erythropoiesis might be considered.

Single injection of 600,000 IU vitamin D (3?) did not change anemia 12 weeks later

Effect of Vitamin D Supplements On Hemoglobin Concentration in Patients with Iron Deficiency Anemia and Concurrent Vitamin D Deficiency: A Randomized Single Blind Placebo Controlled Trial, Abstract 5173
Pankaj Malhotra1, Basavaraj GS*,2, Naresh Sachdeva*,2, Jasmina Ahluwalia*,2 and Sanjay Bhadada*,2
1 Internal Medicine, Postgraduate Institute of Medical Education & Research (PGIMER), CHANDIGARH, India,
2 PGIMER, Chandigarh, India

Background: The effect of vitamin D replacement on hemoglobin concentration in subjects with concurrent iron deficiency anemia and vitamin D deficiency is not known.

Methods: In a single blinded randomized placebo controlled study, thirty subjects with iron deficiency anemia (serum ferritin < 15 ug/dl) were randomized to intervention arm (vitamin D 6 lakh IU IM once) or placebo. In all subjects, iron deficiency was corrected with parental iron. All the causes other than iron deficiency were excluded with appropriate investigation. The primary end point was rise in hemoglobin concentration.

Results: Baseline age, BMI, hemogram, levels of serum ferritin, 25(OH)D and PTH were similar in both the arms. Twelve weeks after vitamin D replacement, there was significant increase in 25 (OH) D levels and decrease in PTH levels in subjects with intervention arm compared to placebo arm (p<0. 01). The increment in serum ferritin in both the group was similar. There was no further increase in hemoglobin concentration in intervention arm compared to placebo arm.

Conclusion: Vitamin D replacement in subjects with iron deficiency anemia after iron correction does not improve hemoglobin concentration further.

Wonder: did this study use vitamin D2 instead of D3?

See also VitaminDWiki

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