Deficiencies of Serum Ferritin and Vitamin B<sub>12</sub>, but not Folate, are Common in Adolescent Girls Residing in a Slum in Delhi

Bansal, Priyanka Gupta; Toteja, Gurudayal Singh; Bhatia, Neena; Vikram, Naval Kishore; Siddhu, Anupa; Garg, Ashok; Roy, Ashok Kumar

doi:10.1024/0300-9831/a000219

Cited by 24 publications

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“…Vitamin B12 deficiency is comparatively higher in adolescents and continues to be so in other stages. Studies among adolescents [37] and non-pregnant women [38] from other parts of India report a high prevalence of vitamin B12 deficiency but no folic acid deficiency. Studies of pregnant women in India have reported lower proportions of folic acid deficiency (20-30%) but higher proportions of vitamin B12 deficiency (50-80%) compared to our study [4,23,24].…”

Section: Discussionmentioning

confidence: 99%

Folate, vitamin B12, ferritin and haemoglobin levels among women of childbearing age from a rural district in South India

et al. 2017

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Background: Low folate and vitamin B12 levels have negative effect on pregnancy outcomes but there is paucity of data on their levels among Indian women. Ferritin and haemoglobin are associated with maternal mortality and low birth-weight. Our aim was to estimate the prevalence of deficiency of serum folate and vitamin B12, and low levels of serum ferritin and blood haemoglobin among women of childbearing age from a rural population of South India. Methods: We conducted a community-based cross-sectional study among 15-35 year women in a rural district. We used multistage stratified random sampling. Trained staff interviewed women to collect socio-demographic information and draw blood samples. We analysed samples for serum folate, vitamin B12, ferritin and blood haemoglobin levels and computed means and medians. We computed the proportion of deficiency based on cut-offs recommended by WHO. We examined the association of levels with age, parity and current pregnancy or breastfeeding by multi-variable regression using Stata 13.0. Results: We recruited 979 women. One-fifth (185, 19%) were pregnant and one-fifth (196, 20%)were breastfeeding. Median serum folate levels were 2.5 ng/ml (IQR, 1.2-4.8), median vitamin B12 levels were 228.0 pg/ml (IQR, 121 -390), median ferritin levels were 13.0 μg/l (IQR, 6.0 -20.0) and median blood haemoglobin levels were 12.1 mg/dl (IQR, 10.7 -13.6). Low levels of serum folate, vitamin B12, ferritin and haemoglobin were found in 57% (95% CI, 54-60%), 44% (95% CI, 41-48%), 46% (95% CI, 43-49%) and 28% (95% CI, 25-31%) respectively. Women with folic acid deficiency had two times higher prevalence of having vitamin B12 deficiency. In adjusted regression analysis folate levels were lower in older and breastfeeding women, but not associated with parity and were higher among pregnant women. Similar associations were not found with Vitamin B12 deficiency. Ferritin levels were higher in older women; but not associated with parity, pregnancy or breastfeeding. Haemoglobin levels were lower in pregnant and breastfeeding women. Conclusion: Our findings suggest that folic acid, vitamin B12 and iron deficiency are important public health problems in India. We observed that half of the women of childbearing age were deficient in these nutrients. Folic acid and vitamin B12 deficiencies co-exist and should be supplemented together.

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Section: Discussionmentioning

confidence: 99%

Folate, vitamin B12, ferritin and haemoglobin levels among women of childbearing age from a rural district in South India

et al. 2017

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“…Areas identified as having populations at risk of low vitamin B12 intakes include the Indian subcontinent [ 16 ], Central and Southern America, and parts of Africa [ 17 ]. Whether people who emigrate from these areas are similarly susceptible to low vitamin B12 intakes will be of interest to their new country.…”

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confidence: 99%

Vitamin B12 Status of Various Ethnic Groups Living in New Zealand: An Analysis of the Adult Nutrition Survey 2008/2009

et al. 2018

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Vitamin B12 deficiency leads to serious health problems, whilst sub-optimal status is associated with raised biochemical markers of disease risk. Identifying at-risk groups could benefit both individuals and public health. Dietary data were sourced from the New Zealand Adult Nutrition Survey 2008/2009, involving a nationally representative sample of 4721 participants. Ethnic groupings were by regional origin: Māori and Pacific Islands, New Zealand European, East and South-East Asian, and South Asian. Diets were assessed using 24-h recalls and from responses to a questionnaire. Blood samples were obtained from a subset (n = 3348). The mean (95% CI) vitamin B12 intake of the Māori and Pacific Islands group was 5.1 (4.7, 5.5) µg/day, New Zealand Europeans 4.1 (3.8, 4.3) µg/day, East and South-East Asians 4.5 (3.7, 5.3) µg/day, and South Asians 3.0 (2.5, 3.6) µg/day. Overall, 20.1% of the sample had vitamin B12 inadequacy (<221 pmol/L). South Asians had the lowest vitamin B12 concentration at 282 (251, 312) pmol/L, whilst Māori/Pacific and East/South-East Asians had the highest, at 426 (386, 466) and 425 (412, 437) pmol/L, respectively. The main dietary determinant of serum vitamin B12 concentration was whether or not people ate red meat, with a regression coefficient of 27.0 (95% CI: 6.6, 47.5). It would be helpful for health agencies to be aware of the potential for compromised vitamin B12 status in South Asian communities.

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“…Ferritin is used a marker of iron deficiency in various healthcare facilities across the globe [14]. Being an acute phase reactant, serum ferritin level is prone to be higher in overweight and obese people, because of a state of subclinical, but generalized inflammation in them [15–17].…”

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confidence: 99%

Ferritin Is a Marker of Inflammation rather than Iron Deficiency in Overweight and Obese People

et al. 2016

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Background. In clinical practice, serum ferritin is used as a screening tool to detect iron deficiency. However, its reliability in obesity has been questioned. Objectives. To investigate the role of ferritin in overweight and obese people, either as a marker of inflammation or iron deficiency. Methods. On the basis of body mass index (BMI), 150 participants were divided into three equal groups: A: BMI 18.5–25 kg/m2, B: BMI 25–30 kg/m2, and C: BMI > 30 kg/m2. Serum iron, total iron binding capacity (TIBC), transferrin saturation, ferritin, C-reactive protein, and hemoglobin (Hb) were measured for each participant and analyzed through SPSS version 16. One-way ANOVA and Pearson's correlation tests were applied. Results. Ferritin was the highest in group C (M = 163.48 ± 2.23, P < 0.001) and the lowest in group A, (M = 152.78 ± 1.81, P < 0.001). Contrarily to ferritin, transferrin was the lowest in group C, (M = 30.65 ± 1.39, P < 0.001) and the highest in group A, (M = 38.66 ± 2.14, P < 0.001). Ferritin had a strong positive correlation with both BMI (r = 0.86, P < 0.001) and CRP (r = 0.87, P < 0.001) and strong negative correlation with Hb, iron, TIBC, and transferrin saturation (P < 0.001). Conclusion. Ferritin is a marker of inflammation rather than iron status in overweight and obese people. Complete iron profile including transferrin, rather than serum ferritin alone, can truly predict iron deficiency in such people.

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Deficiencies of Serum Ferritin and Vitamin B₁₂, but not Folate, are Common in Adolescent Girls Residing in a Slum in Delhi

Cited by 24 publications

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Folate, vitamin B12, ferritin and haemoglobin levels among women of childbearing age from a rural district in South India

Folate, vitamin B12, ferritin and haemoglobin levels among women of childbearing age from a rural district in South India

Vitamin B12 Status of Various Ethnic Groups Living in New Zealand: An Analysis of the Adult Nutrition Survey 2008/2009

Ferritin Is a Marker of Inflammation rather than Iron Deficiency in Overweight and Obese People

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Deficiencies of Serum Ferritin and Vitamin B12, but not Folate, are Common in Adolescent Girls Residing in a Slum in Delhi

Cited by 24 publications

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Folate, vitamin B12, ferritin and haemoglobin levels among women of childbearing age from a rural district in South India

Folate, vitamin B12, ferritin and haemoglobin levels among women of childbearing age from a rural district in South India

Vitamin B12 Status of Various Ethnic Groups Living in New Zealand: An Analysis of the Adult Nutrition Survey 2008/2009

Ferritin Is a Marker of Inflammation rather than Iron Deficiency in Overweight and Obese People

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Deficiencies of Serum Ferritin and Vitamin B₁₂, but not Folate, are Common in Adolescent Girls Residing in a Slum in Delhi