125 - Vitamin D and Anemia in Children and Adolescents in an Urban Multiethnic Community Hospital

Vitamin D insufficiency (VDI) and deficiency (VDD) are increasingly common. Vitamin D in food, sunlight and supplement require a normal functioning liver and kidney to have adequate 1,25OH₂ vitamin D. Several studies conducted in recent years have suggested that VDD is associated with anemia in healthy adults. It is speculated that by down-regulating pro-inflammatory cytokines and hepcidin, vitamin D may increase iron availability and support erythropoiesis. Confounding factors for VDD include obesity and nutritional status. There are no studies on relationship between VDD and anemia in children and adolescents in a multiethnic population.

 

Objective: To explore possible association between VDI and VDD and anemia in children and adolescents.

Design/Methods:

This was a retrospective chart review of children and adolescents aged 2 to 18 years followed at Flushing Hospital Medical Center between March 2019 and March 2022 with 25OH vitamin D level. Data extracted from EHR included demographics (age, gender, ethnicity), BMI, level of 25OH vitamin D, history of fracture, hemoglobin, and red blood cell indices. Normal 25OH vitamin D is a level between 30-100 ng/mL, between 20-29 ng/mL is VDI, and < 20 ng/mL is VDD. Anemia is defined as hemoglobin < 12.0 g/dL. BMI 85-94^th percentile is overweight and >95^th percentile is obese. Data were analyzed using SPSS and percentages, p< 0.05 was considered significant.

Results:

Of 84 patients identified to have 25OH vitamin D result on file, 54% were female ranging in age 13.9+2.5 years. Of reported ethnicities, majority was Hispanic (80%) followed by Asian (7%) and African-American (4%). VDD was in 83% (n=70) and VDI in 15% (n=13). Total of 9 patients (11%) were anemic and less than half (44%, n=4) were iron deficient. Of the anemic patients, 7 were in VDD group (10%) and 2 were in VDI group (15%). Almost all anemic patients (88%) were overweight (n=2) or obese (n=6), (OR=3.9, p=0.03) and one (11%) with normal BMI. Of the third with normal BMI (32%), three quarters (74%, 20 of 27) were VDD and remainder quarter (26%) was VDI. Majority of obese (90%, 39/43) and overweight (91%, 11/12) children were VDD. Four patients (5%) had a fracture and VDD.

Conclusion(s): In our small multiethnic sample, VDI and VDD were not associated with anemia but associated with higher BMI. Healthcare providers need to screen for VDI and VDD in all children and adolescents especially with in those whose BMI >85^th percentile and provide appropriate intervention when identified.