Ali FETTAH, Gokce Pinar REİS, İbrahim ERTEN, Atilla ÇAYIR

The effect of serum vitamin D levels on anemia and iron parameters in children and review of the literature

Anemi, vitamin D ve demir eksikliği halen tüm dünyada önemli bir halk sağlığı problemidir. Vitamin D'nin kemik sağlığı dışında hücre proliferasyonu ve diferansiasyonu, apoptozis, immün sistem modülasyonu ve anti-inflamatuar etkileri de mevcuttur. Ayrıca D vitaminin demir metabolizması ve eritropoez üzerine de etki ettiği düşünülmektedir. Bu çalışmada, çocuklarda D vitamini eksikliği ile anemi ve demir eksikliği arasındaki ilişkinin gösterilmesi amaçlanmıştır. Erzurum Bölge Eğitim ve Araştırma Hastanesi Çocuk Endokrin ve Çocuk Hematoloji-Onkoloji polikliniğine Ocak 2014 ile Kasım 2015 tarihleri arasında başvuran, yaşları 1-18 arasında olan 105 hasta çalışmaya dahil edildi. Enfeksiyon/enflamasyon, kronik hastalık, talasemi taşıyıcısı bulguları olan hastalar çalışma dışı bırakıldı. Hastaların kayıtlarından kan sayımı, serum 25-hidroksi vitamin D (25D), serum demir, serum demir bağlama kapasitesi ve serum ferritin geriye dönük olarak incelendi. Çalışmamızda 25D düzeyi eksik, yetersiz ve normal olan gruplar arasında anemi görülme sıklığı (%11.1, %27.8, %11.9, sırasıyla, p=0.2), demir eksikliği görülme sıklığı (%33.3, %38.9, %33.3, sırasıyla, p=0.9), serum demir düzeyi (67.7±35.3 µgr/dL, 63.2±31.9 µgr/dL, 67.5±33.7 µgr/dL, sırasıyla p=0.8), serum ferritin düzeyi (26±18.9 mg/L, 24±16.4 mg/L, 22.5±18.1 mg/L, sırasıyla, p=0.4) ve transferrin satürasyon indeksi (%26.7±19.1, %22.5±13.2, %25.5±19.7, sırasıyla, p=0.7)açısından fark görülmedi. Çalışmamızda D vitamini ile anemi ve demir eksikliği arasında bir ilişki gösterilememiştir. D vitamininin, demir metabolizması ve eritropoez üzerine olan etkisini, enflamasyon yolakları ve hepsidin aracılığıyla yaptığını düşünmekteyiz. Sağlıklı çocuklarda D vitamini eksikliği ile anemi/demir metabolizması arasındaki ilişkiyi gösterecek ileri çalışmalara ihtiyaç vardır

Çocuklarda serum D vitamini düzeyinin anemi ve demir parametreleri üzerine etkisi ve literatür derlemesi

Anemia, vitamin D and iron deficiency remains a major public health problem all over the world. Vitamin D is known for its crucial role in bone and mineral metabolism and is increasingly recognized to have extra-skeletal effects on cell proliferation and differentiation, immune function and anti-inflammatory effects. In addition, vitamin D is thought to have effect on iron metabolism and erythropoiesis. The aim of this research was to determine the effect of serum 25(OH) vitamin D (25D) on anemia and iron deficiency in childhood. A hundred and five patients aged between 1-18 years who were admitted Pediatric Hematology-Oncology and Pediatric Endocrinology out-patient clinic between January 2014 and November 2015 in Erzurum Regional and Research Hospital were enrolled in the study. The patients who had signs of infection/inflammation, chronic disease and thalassemia trait were excluded from the study. Data of patients, including gender, age, complete blood count, serum levels of 25D, iron, iron binding capacity and ferritin were retrospectively reviewed. In our study, the prevelance of anemia (11.1%, 27.8%, 11.9%, respectively, p=0.2), the prevelance of iron deficiency (33.3%, 38.9%, 33.3%, respectively, p=0.9), level of serum iron (67.7±35.3 µgr/dL, 63.2±31.9 µgr/dL, 67.5±33.7 µgr/dL, respectively, p=0.8), level of serum ferritin (26±18.9 mg/L, 24±16.4 mg/L, 22.5±18.1 mg/L, respectively, p=0.4) and index of transferrin saturation (26.7±19.1%, 22.5±13.2%, 25.5±19.7, respectively, p=0.7) was not different between 25D deficient, insufficient and normal groups. Our study has not shown an association between anemia, iron deficiency and vitamin D. We think that vitamin D has effect on iron metabolism and erythropoiesis through inflammation pathways and hepsidin. Further studies is needed to evaluate the relation between vitamin D and anemia/iron metabolism

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