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Anemia in children 3.5 X more likely if low vitamin D – March 2018

Poor vitamin D status increases the risk of anemia in school children: National Food and Nutrition Surveillance.

Nutrition. 2018 Mar;47:69-74. doi: 10.1016/j.nut.2017.09.008. Epub 2017 Oct 12.

Nikooyeh B1, Neyestani TR2.

  • 1 Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • 2 Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. tneyestani at sbmu.ac.ir.


OBJECTIVES:
This study aimed to investigate the association between 25-hydroxyvitamin D (25OHD) concentrations and the risk of anemia in a large cohort of children with consideration for the effects of sex, body mass index (BMI), serum intact parathyroid hormone (iPTH) concentrations, and iron level status.

METHODS:
A total of 937 children (493 boys, 444 girls) ages 9 to 12 y were enrolled in a cross-sectional study. The children underwent various examinations including anthropometric measurements and blood sampling.

RESULTS:
Overall, 13.3% of the children were anemic and 64.2% and 28.1% of the subjects had a vitamin D deficiency (<25 nmol/L) and insufficiency (25-50 nmol/L), respectively. Approximately 13% of the children had concurrent low hemoglobin and hypovitaminosis D levels. The prevalence of hypovitaminosis D in the group of children with anemia was 96.8% compared with 91.6% in the non-anemic group (P = 0.046). Mean 25(OH)D concentrations were significantly lower in the anemic children compared with the non-anemic children (19.6 ± 13.3 vs. 24.0 ± 23.1 nmol/L; P = 0.003). After controlling for sex and BMI, children with a vitamin D deficiency were almost 3.45 times more likely to be anemic compared with children with a vitamin D sufficiency (95% confidence interval CI, 1.21-9.81). The increased risk of anemia was found to start significantly at 25(OH)D < 44 nmol/L (17.6 ng/mL; odds ratio: 2.29; 95% CI, 1.07-4.91, P = 0.032).

CONCLUSIONS:
These findings strongly suggest an association between low circulating concentrations of 25(OH)D and anemia in a large, representative sample of children, even after adjustment for sex, age, BMI, and iPTH.

PMID: 29429539 DOI: 10.1016/j.nut.2017.09.008

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