Effects of iron on Vitamin D metabolism: A systematic review

Azizi-Soleiman, Fatemeh; Vafa, Mohammadreza; Abiri, Behnaz; Safavi, Mohammadreza

doi:10.4103/2008-7802.195212

Cited by 45 publications

(43 citation statements)

References 36 publications

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“…and SFC levels could be attributed to a modulatory effect for VD on hepcidin/Fpn pathway inducing more iron release, thus increasing SFC, to be available for more synthesis of hemoglobin, so increasing Hb conc. These findings and assumption supported that previously reported by Bacchetta et al (10) who documented that VD is a potent regulator of the hepcidin-Fpn axis in humans and Azizi-Soleiman et al (32) who found VDD is associated with higher hepcidin level in the body. Smith & Tangpricha (33) attributed the regulatory effect of VD on hepcidin/Fpn axis to a direct suppression of hepcidin mRNA transcription.…”

Section: Discussion:-supporting

confidence: 91%

Gestational Iron Deficiency Anemia Is Not Simply a Consequence of Iron Deficiency: An Observational Study for Cofounders.

HeshamMAboRagab¹,

EhabBarakat²,

OmmniaAbdulla³

2018

IJAR

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Objectives:To evaluate serum levels of vitamin D (VD), hepcidin, interleukin (IL)-6 and iron indices in pregnant women Patients & Methods: 88 pregnant women fulfilling the inclusion criteria underwent full clinical examination and gave blood samples for determination of hemoglobin concentration (Hb. Conc.), and ELISA estimation of serum 25-hydroxy VD (25OH-VD), ferritin concentration (SFC), hepcidin and IL-6 at the 6 th wk gestational age (Booking time) and underwent re-determination of Hb. Conc. at start of the 3 rd trimester and Hb. Deficit was calculated. Study outcome included determination of the frequency of iron deficiency (ID), iron deficiency anemia (IDA) and VD deficiency (VDD) and evaluation of the relations between these parameters. Results: At booking time, 17 women were anemic (Hb. Conc. <11 gm/dl), while 14 women had SFC<15 ng/ml, for a frequency of anemia, ID and IDA of 19.3%, 15.9% and 11.4%, respectively. At the 3 rd trimester, 35 women had Hb. Conc. <11 gm/dl, thus the frequency of IDA was doubled during pregnancy with significantly (p=0.0029) higher frequency of anemic women and significantly (p=0.0007) lower mean Hb. Conc. compared to booking time with a median decrease of Hb. deficit by 4.96% (95% ICR: -7 to -3.23). At booking time, 17 women had insufficient VD levels and 64 women had VDD. At booking Hb. Conc. and deficit was significantly correlated with serum FC, 25OH-VD, hepcidin and IL-6. Serum 25OH-VD level showed significant correlation with SFC, hepcidin and IL-6 levels, and serum hepcidin levels was significantly correlated with serum FC and IL-6. Regression analysis defined at booking high serum hepcidin and IL-6 as significant negative, while high serum 25OH-VD level as significant positive predictor for oncoming 3 rd trimester Hb. conc. For prediction of the extent of Hb. deficit, at booking high serum 25OH-VD was negative (β=-0.307, p=0.004), while serum IL-6 level was positive (β=0.235, p=0.026) significant predictors for high deficit. Conclusion: Gestational IDA is a progressive condition weakly responding to iron supplemental therapy. IDA is a multi-factorial condition strongly associated with VDD, disturbed immune milieu and deregulated iron homeostasis. VDD plays a crucial role in pathogenesis of ADI.

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Section: Discussion:-supporting

confidence: 91%

Gestational Iron Deficiency Anemia Is Not Simply a Consequence of Iron Deficiency: An Observational Study for Cofounders.

HeshamMAboRagab¹,

EhabBarakat²,

OmmniaAbdulla³

2018

IJAR

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“…The major findings were the presence of vitamin D deficiency in a greater percentage of infants with iron-deficiency anemia compared to the other groups and a significant correlation between hemoglobin and 25(OH)D levels. These results confirm the previous observation that changes in vitamin D metabolism are intricately related to iron deficiency, 80 because heme-bound iron is essential in the hydroxylation process of vitamin D. 81 …”

Section: Vitamin D Deficiency and Anemia Risksupporting

confidence: 90%

Vitamin D deficiency and anemia risk in children: a review of emerging evidence

Uwaezuoke¹

2017

PHMT

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There has been renewed scientific interest in the sequelae of vitamin D deficiency, given the emerging evidence on the diverse biologic functions of vitamin D, besides its fundamental role in bone and mineral metabolism. For the past decade, the evidence in the medical literature pointing to a relationship between anemia risk and vitamin D deficiency has been accumulating. This paper critically reviews the current evidence linking vitamin D deficiency to anemia risk in children. The synthesized evidence indicates that the studies, which were preponderantly conducted among the adult population, not only reported a bidirectional relationship between vitamin D deficiency and anemia but also showed a racial effect. In studies conducted among children, similar results were reported. Although the causal association of vitamin D deficiency with anemia risk (especially iron-deficiency anemia) remains debatable, the noncalcemic actions of the vitamin and its analogs hold prospects for several novel clinical applications. There is, however, unanimity in many reports suggesting that vitamin D deficiency is directly associated with anemia of chronic disease or inflammation. Despite the advances in unraveling the role of vitamin D in iron homeostasis, further research is still required to validate causality in the relationship between vitamin D deficiency and anemia, as well as to determine its optimal dosing, the ideal recipients for therapeutic intervention, and the preferred analogs to administer.

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“…Clinically, multiple suggestions were provided for the association between VDD and anemia as Thomas et al (44) attributed the effect of VDD on HC in pregnant women to both a direct effect and an indirect effect mediated by erythropoietin. Interestingly, Azizi-Soleiman et al (45) detected a positive relationship between iron status and VD and attributed it a possible reciprocal relation where VDD is associated with higher HPC level causing reduction of iron release which in turn induced reduction of activation of hydroxylases that yield calcitriol, so constituting a vicious circle. Recently, Liu et al (46) experimentally in antenatal lipopolysaccharide-treated rats found VD increased the methylation percentage of the VD-response element in IFN-γ-promoter region and suppressed its LPS-induced and reported clinically an association between maternal VD exposure during pregnancy and neonatal IFN-γ levels, so suggested that supplementation of VD could suppress IFN-γ production with its hazardous maternal, fetal and neonatal effects.…”

Section: Results:-mentioning

confidence: 99%

Can Vitamin D Supplemental Therapy Improve Pregnancy-Associated Anemia? An Interventional Prospective Clinical Trial.

MD¹,

MD²

2018

IJAR

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Objectives: To evaluate impact of vitamin D supplemental therapy (VD-ST) and iron ST (IST) on hemoglobin concentration (HC) in pregnant women. Patients & Methods: 187 women pregnant were clinically evaluated and gave blood samples at 1 st trimester for estimation of HC and serum 25OH-VD, ferritin concentration (FC), hepcidin (HPC) and interleukin-6 (IL-6). Women were categorized according to the levels of estimated parameters into control and study groups AD. Women of groups A and C received VD-ST alone, group B received IST alone and group D received both ST. At delivery, HC, extent of change and frequency of pregnancy-associated anemia (PAA) were determined. Results: At 1 st trimester, 71.7% women were anemic and 38.5% had hypoferremia, 77% had VD deficiency (VDD) and 59.4% had both VDD and PAA. Serum HPC and IL-6 levels in anemic women especially those had VDD were significantly higher than control women. At delivery, 35% of control women developed PAA and mean HC was significantly lower than 1 st trimester HC with a median deficit of 4.72 gm/dl (IQR: 2.8-6.4) among studied population. Frequency of anemic women in groups B-D was decreased at delivery by 21.7%, 30.8% and 30.6%, respectively. Statistical analyses defined high serum HPC and IL-6 levels at 1 st trimester as specific early predictors for PAA development, but early institution of ST especially VD-ST is one of the best significant predictors for improved HC at time of delivery. Conclusion: VDD, hypoferremia, higher HPC and IL-6 levels constitute a vicious circle entrapping pregnant women and inducing iron deficiency anemia at delivery. Early institution of VD-ST and IST can burst this circle and induce improvement of HC up to normal range in about 30% of women presented by PAA. Thus, early estimation of HC and serum VD can be used as a guide for early institution of ST.

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Effects of iron on Vitamin D metabolism: A systematic review

Cited by 45 publications

References 36 publications

Gestational Iron Deficiency Anemia Is Not Simply a Consequence of Iron Deficiency: An Observational Study for Cofounders.

Gestational Iron Deficiency Anemia Is Not Simply a Consequence of Iron Deficiency: An Observational Study for Cofounders.

Vitamin D deficiency and anemia risk in children: a review of emerging evidence

Can Vitamin D Supplemental Therapy Improve Pregnancy-Associated Anemia? An Interventional Prospective Clinical Trial.

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