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

Abstract

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.

Vitamin D-Resistant Rickets Diagnostics and Treatment Challenges at Muhimbili National Hospital, Tanzania

“…Our case also presented with anemia that can be explained by the fact vitamin D has a vital role in promoting erythropoietin by downregulating proinflammatory cytokines and activating the erythropoietin hormone itself [24][25][26]. Other typical features of rickets like craniotabes, dental deformities, and rachitic rosary and Harisson's groove were not present in this child.…”

Is There An Association Between Vitamin B12 Level and Vitamin D Status in Children?

“…The relationship between vit D level and vit B12 was studied only in cases with autoimmune hypothyroidism and atrophic gastritis. Aktaş from our country reported that there is a negative correlation between vit B12 and vit D levels in patients with autoimmune hypothyroidism 11. Zilli and colleagues reported that vit D deficiency is common in individuals with atrophic gastritis and a similar etiopathogenesis causes vit B12 deficiency 12.…”

Parenteral iron therapy and phosphorus homeostasis: A review

“…Additionally, iron deficiency anemia accounts for 50% of all anemia cases and affects an estimated 1.24 billion individuals worldwide, 47 predominantly women and children 7 and is often seen in combination with other nutritional disorders. Vitamin D affects iron homeostasis and erythropoiesis, and low vitamin D levels have been associated with iron deficiency in both adults and children 48,49 . Synthesis of FGF23 as well as proteolytic inactivation of iFGF23 is increased in proportion to the severity of iron deficiency in humans 50 .…”

“…Vitamin D affects iron homeostasis and erythropoiesis, and low vitamin D levels have been associated with iron deficiency in both adults and children. 48,49 Synthesis of FGF23 as well as proteolytic inactivation of iFGF23 is increased in proportion to the severity of iron deficiency in humans. 50 The increase in FGF23 results from an increase in FGF23 mRNA transcription, which has been demonstrated both in vivo (from a low-iron diet) and in cultured cells (from treatment with an iron chelator); this may be regulated by the transcription factor hypoxia inducible factor-1α.…”