Vitamin D Status in Egyptian Adolescent Females with Iron Deficiency Anemia and Its Correlation with Serum Iron Indices

Abstract

Background: In Egypt, it seems that adolescent girls are a candidate for Vitamin D Deficiency (VDD), mostly due to inadequate sun exposure as a result of the culture and social dress codes and dietary factors. Currently, there is growing evidence that VDD is associated with Iron Deficiency Anemia (IDA).

Aim: To investigate the frequency of VDD in adolescent females with IDA in comparison to healthy control and demonstrate whether VD level was correlated with serum iron indices.

Subjects and methods: Forty adolescent females with known cases of IDA (group 1) and 30 healthy females matched for age as a control (group 2) were selected. We compared the differences between the two groups to determine the degree of VD level; where VDD was defined as 25-hydroxyvitamin D [25(OH)D] ≤20 ng/mL, vitamin D insufficiency (VDI) as 25(OH) D of 20-30 ng/mL, and vitamin D sufficiency (VDS) as 25(OH)D >30 ng/mL. Body mass index (BMI), complete blood count (CBC), serum iron, total iron binding capacity (TIBC), serum ferritin, serum creatinine, ionized calcium and 25(OH)D were measured for all participants.

Results: We found that subnormal vitamin D (VDD and VDI) was more frequent in the IDA group (75%) than control (40%), (p = 0.025); where 19 adolescent female patients (47.5%) were VDD, 11 (27.5%) were VDI and 10 (25%) were VDS, while in the control group, VDD was present in 4 (20%), VDI in 4 (20%) and VDS in 12 (60%) respectively. There was not any significant correlation between serum VD and serum iron indices (r =0.168, p < 0.05) and Hb (r = 0.360, p < 0.001). There was no significant difference in serum hemoglobin level between IDA patients with subnormal VD and those with VDS. The mean level of serum 25(OH) D was significantly lower in winter months than summer in both groups; (16.87 vs. 31.57 mg/dL, p < 0.001) and (31.9 vs. 35.04 mg/dL, p < 0.001) respectively. BMI, Iron, TIBC and seasonal variation were not predictors of 25(OH) D levels in adolescent girls with IDA.

Conclusion: VDD has a higher frequency in Egyptian adolescent females with IDA than healthy control. However, vitamin D levels were not significantly correlated with iron indices. Our result might direct the attention for measuring vitamin D level in patients with IDA with the possibility of VD supplementation with iron.

Keywords: Vitamin D; WHO; adolescent females; iron deficiency anemia; reproductive health; serum iron indices..