Vitamin D and anemia

Abstract

The significant prevalence of vitamin D deficiency (VDD) in many groups of children is well known today. Indeed, studies showing VDD in various chronic childhood conditions are no longer surprising or novel. In light of this, the report in this issue of The Journal from Atkinson et al at Johns Hopkins is not surprising. Using data from National Health and Nutrition Examination Survey, the authors found an association between low levels of 25-Hydroxyvitamin D and anemia in children. Superficially, one might predict that some of the social and nutritional conditions that could lead to VDD also would be risks for anemia; the study, however, controlled for such obvious confounders as obesity, as well as other measures of nutritional adequacy. Although the study was not designed to demonstrate causality, there are intriguing possible explanations for this finding. Among the many non-skeletal effects of calcitriol, there may be a direct effect on bone marrow; the known immunomodulatory effects of calcitriol might modulate cytokine production, modifying inflammatory pathways that could contribute to anemia.Anemia and VDD are common in children, have serious consequences, and now may be linked.Article page 153▶ The significant prevalence of vitamin D deficiency (VDD) in many groups of children is well known today. Indeed, studies showing VDD in various chronic childhood conditions are no longer surprising or novel. In light of this, the report in this issue of The Journal from Atkinson et al at Johns Hopkins is not surprising. Using data from National Health and Nutrition Examination Survey, the authors found an association between low levels of 25-Hydroxyvitamin D and anemia in children. Superficially, one might predict that some of the social and nutritional conditions that could lead to VDD also would be risks for anemia; the study, however, controlled for such obvious confounders as obesity, as well as other measures of nutritional adequacy. Although the study was not designed to demonstrate causality, there are intriguing possible explanations for this finding. Among the many non-skeletal effects of calcitriol, there may be a direct effect on bone marrow; the known immunomodulatory effects of calcitriol might modulate cytokine production, modifying inflammatory pathways that could contribute to anemia. Anemia and VDD are common in children, have serious consequences, and now may be linked. Article page 153▶ Vitamin D, Race, and Risk for Anemia in ChildrenThe Journal of PediatricsVol. 164Issue 1PreviewTo examine the association between 25-hydroxyvitamin D [25(OH)D] deficiency and anemia in a cohort of otherwise-healthy children and to determine whether race modifies the association between 25(OH)D status and hemoglobin (Hgb). Full-Text PDF