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Anemia associated with lower than 20 ng vitamin D among elderly – Jan 2011

Prevalence of 25-hydroxyvitamin D deficiency in subgroups of elderly persons with anemia: association with anemia of inflammation.

Blood. 2011 Jan 14.
Perlstein TS, Pande R, Berliner N, Vanasse GJ.
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.

Anemia and vitamin D deficiency are conditions that both result in significant morbidity and increase with age. The potential relationship between them remains poorly understood, particularly in the elderly. We utilized the Third National Health and Nutrition Examination Survey (NHANES III) to examine the association of vitamin D deficiency with anemia subtypes in individuals aged > 60 years. Vitamin D deficiency was defined as serum levels < 20 ng/mL and anemia was defined according to World Health Organization criteria.

Vitamin D deficiency was associated with anemia prevalence independent of age, sex, or race/ethnicity (OR 1.47, 95% CI 1.06; 2.05, p=0.02) and varied significantly by anemia subtype (p overall =0.003).
The prevalence of vitamin D deficiency was

  • 33.3% in the non-anemic population,
  • 56% in anemia of inflammation (AI) (p=0.008), and
  • 33.0% in unexplained anemia (p=0.55).


Non-Hispanic blacks had a 7-fold increased risk of AI compared with whites, and this was partially attenuated after adjusting for vitamin D deficiency.

These data demonstrate that vitamin D deficiency is associated with specific subtypes of anemia in the elderly, especially in those with AI.
Vitamin D may suppress inflammatory pathways, and studies to determine whether vitamin D supplementation ameliorates AI are warranted. PMID: 21239700


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