Eman H. EL-Adawy*, Fawkia E. Zahran, Gehan A. Shaker and Amal Seleem Pages 519 - 525 ( 7 )
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.
Vitamin D, iron deficiency anemia, adolescent females, serum iron indices, WHO, reproductive health.
Department of Internal Medicine, Endocrinology Unit, Specialized Medical Hospital, Mansoura University, Department of Internal Medicine, Alazhar Hospital, Alazhar University, Cairo, Department of physiology, Faculty of Medicine, Mansoura University, Department of Biochemistry, Mansour University Hospital, Faculty of Medicine