Background: Anaemia and vitamin D insufficiency (VDI) are among the most common nutritional problems. Anaemia screening is routinely performed; however, screening for VDI is not usually recommended.
Objectives: To study the association between anaemia and VDI and identify the risk factors for VDI.
Methods: We conducted a cross-sectional study of 120 infants aged 6-12 months attending a well-child clinic at Songklanagarind Hospital between December 2020 and November 2021. Sociodemographic data and 24-h food records were also collected. Blood samples were obtained for complete blood count and 25-hydroxyvitamin D [25(OH)D] levels. Logistic regression analysis was used to determine risk factors for VDI.
Results: The mean 25(OH)D level was 22.2 ± 8.9 ng/mL in anaemic infants and 27.2 ± 9.6 ng/mL in non-anaemic infants (P value 0.01). The median (IQR) Hb level was 11.1 g/dL (10.3, 11.4) in the VDI group and 11.4 g/dL (11, 12.1) in the non-VDI group (P value 0.002). The proportion of breastfed infants was higher in infants with anaemia (80%) (P < 0.001) and VDI (85.3%) (P < 0.001). Sunlight exposure <15 min/day (odds ratio [OR] 3.84; 95% confidence interval [CI]: 1.23-12.00; P = 0.020) was a risk factor, and vitamin D intake (OR 0.37; 95% CI: 0.20-0.74; P = 0.004) was a protective factor for VDI.
Conclusion: Infants with anaemia, short duration of sunlight exposure, breastfeeding, low vitamin D intake, and low iron intake were more likely to be vitamin D insufficient. However, after adjustment in the multivariate analyses, only sunlight exposure and vitamin D intake were significantly associated with vitamin D insufficiency.
Keywords: anaemia; anaemia screening; breastfeeding; infants; vitamin D insufficiency; vitamin D supplementation.
Anaemia and vitamin D insufficiency (VDI) are the 2 most common global nutrition-related problems. Recently, data have been reported on the association between anaemia and VDI; however, no data exist for infants in Thailand. We assessed the vitamin D levels in infants attending a well-child clinic and investigated possible correlations with anaemia. We found that infants with anaemia, short duration of sunlight exposure, breastfeeding, low vitamin D intake, and low iron intake were more likely to be vitamin D insufficient. However, anaemia was not shown to be an independent risk factor for VDI. Risk factor and protective factor for VDI were short duration of sunlight exposure and adequate vitamin D intake, respectively. Vitamin D supplementation to infants has been recommended in many countries, yet, it has not been implemented in Thailand or other tropical countries. We suggest that VDI should be of concern in infants with anaemia or breastfeeding, particularly among those with inadequate sunlight exposure and low vitamin D intake. Implementing vitamin D supplementation should be considered for future practice.
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