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Association between anaemia and vitamin D insufficiency among 6- to 12-month-old infants: implications for clinical
Sasivara Boonrusmee1, Staporn Kasemsripitak1, Thitiporn Navykarn1
1Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Insights
Infants with anemia are more likely to have vitamin D insufficiency (VDI). Reduced sunlight exposure and low vitamin D intake are key risk factors for VDI in infants.
Area of Science:
- Pediatrics
- Nutritional Science
- Public Health
Background:
- Anemia and vitamin D insufficiency (VDI) are prevalent nutritional issues in infants.
- Routine anemia screening is common, but VDI screening is not standard practice.
Purpose of the Study:
- To investigate the association between anemia and VDI in infants.
- To identify risk factors contributing to VDI in this population.
Main Methods:
- A cross-sectional study involving 120 infants aged 6-12 months.
- Collected sociodemographic data, 24-hour food records, and blood samples for complete blood count and 25-hydroxyvitamin D [25(OH)D] levels.
- Utilized logistic regression analysis to determine VDI risk factors.
Main Results:
- Infants with anemia had significantly lower mean 25(OH)D levels compared to non-anemic infants (P=0.01).
- Higher proportions of breastfed infants were observed in both anemia (80%) and VDI (85.3%) groups (P < 0.001).
- Limited sunlight exposure (<15 min/day) was a risk factor (OR 3.84), while adequate vitamin D intake was protective (OR 0.37) for VDI.
Conclusions:
- Anemia, limited sunlight exposure, breastfeeding, and low vitamin D/iron intake are associated with VDI in infants.
- Multivariate analysis confirmed sunlight exposure and vitamin D intake as significant factors associated with VDI.
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.
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