Assessment of Vitamin A Status in Patients with Iron Deficiency Anemia

Abstract

Introduction: Iron and vitamin A deficiency are two very prevalent and easily preventable nutrient deficiencies. This study was conducted to assess vitamin A status in patients with iron deficiency anemia and to further study the correlation of vitamin A status with biochemical markers of iron deficiency. Materials and Method: Eighty patients with iron deficiency anemia were enrolled and investigated for a complete blood count, an iron profile, liver, and kidney function tests and plasma retinol binding protein levels. The mean age of patients was 31.14 ± 11.33 years, with a range of 16 to 62 years. Results: Mean hemoglobin was 7.19 ± 2.1 g/dL. Serum iron, ferritin, and transferrin saturation were low in all patients, while total iron binding capacity (TIBC) was elevated in only 74 patients (94.81%). Nineteen patients (23.8%) had vitamin A deficiency, with a mean retinol binding protein (RBP) 0.53 ± 0.13 µmol/L. Vitamin A deficient patients had a mean hemoglobin of 6.8±2.14 gm/dL, mean corpuscular volume (MCV) 71.35 ± 8.86 fL, a mean corpuscular hemoglobin (MCH) 19.43±4.36 pg, mean corpuscular hemoglobin concentration (MCHC) 25.44±4.92 gm/dL, serum iron of 28.21 ± 9.73 mcg/dL, serum ferritin 13.04 ± 12.41 ng/mL, transferrin saturation 6.81 ± 3.07%, and TIBC 427.85 ± 78.57 mcg/dL. Among vitamin A deficient patients, RBP had positive correlation with serum iron and transferrin saturation; while, simultaneously showing negative correlation with serum ferritin and TIBC. Conclusion: Vitamin A deficiency affects iron metabolism, causing abnormal iron trapping and systemic iron deficiency, thus worsening the clinical profile of iron deficiency anemia. This study guides us to screen iron deficiency anemia patients for the concomitant vitamin A deficiency for efficient treatment of such patients.