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Both, anemia and vitamin D deficiency are prevalent in patients with heart failure. According to recent evidence, vitamin D may stimulate erythropoiesis. We measured circulating 25-hydroxyvitamin D (25[OH]D), 1,25-dihydroxyvitamin D (1,25[OH]2D) and hemoglobin (Hb) in a cross-sectional study in 364 end-stage heart failure patients awaiting cardiac...
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... By comparison, relatively little is known about the effect of vitamin D on the hematologic system, although several observational studies found that a low vitamin D status is associated with a higher anemia risk in healthy subjects and patients with chronic kidney disease [8][9][10][11][12]. The proposed underlying mechanisms comprise the increase in proinflammatory cytokines and iron-regulatory hepcidin in situations of insufficient vitamin D levels which lead to iron sequestration and reduced dietary iron absorption [13]. ...
... Therefore, a higher eryptosis associated with vitamin D deficiency could impact the hematologic and cardiovascular system, although the current study did not find any negative impact of the increased eryptosis on hematologic status. It is possible that the higher risk of anemia associated with a low vitamin D status [8][9][10][11][12] and the inverse correlations between 25(OH)D levels and red blood cell count, hemoglobin concentration, and mean corpuscular hemoglobin observed in the German Health Interview Survey for Children and Adolescents [42] are not caused by enhanced eryptosis. Whether higher eryptosis observed in vitamin D-deficient and vitamin D-insufficient individuals in comparison to vitamin D-adequate subjects constitutes a relevant risk for cardiovascular events remains unclear. ...
Vitamin D, besides its classical effect on mineral homeostasis and bone remodeling, can also modulate apoptosis. A special form of apoptosis termed eryptosis appears in erythrocytes. Eryptosis is characterized by cell shrinkage, membrane blebbing, and cell membrane phospholipid disorganization and associated with diseases such as sepsis, malaria or iron deficiency, and impaired microcirculation. To our knowledge, this is the first study that linked vitamin D with eryptosis in humans. This exploratory cross-sectional trial investigated the association between the vitamin D status assessed by the concentration of plasma 25-hydroxyvitamin D (25(OH)D) and eryptosis. Plasma 25(OH)D was analyzed by LC-MS/MS, and eryptosis was estimated from annexin V-FITC-binding erythrocytes by FACS analysis in 2074 blood samples from participants of the German National Cohort Study. We observed a weak but clear correlation between low vitamin D status and increased eryptosis (r = - 0.15; 95% CI [- 0.19, - 0.10]). There were no differences in plasma concentrations of 25(OH)D and eryptosis between male and female subjects. This finding raises questions of the importance of vitamin D status for eryptosis in terms of increased risk for anemia or cardiovascular events.
... Anemia and vitamin D deficiency are two important public health issues that may accompany many acute and chronic diseases. The association between vitamin D deficiency and anemia is found not only with chronic diseases, such as heart failure, diabetes mellitus and chronic kidney disease but also in the healthy population [9,10]. Several observational studies have indicated that there is a reverse relationship between vitamin D levels and anemia in adults [11,12]. ...
HOW TO CITE THIS Alaasswad et al. (2022) Vitamin D deficiency and anemia among pharmacy students Libya. Mediterr J Pharm Pharm Sci. 2 (2): 90-96. https://doi.org/10.5281/zenodo.6780515. Abstract: Prevalence of hypovitaminosis D is not restricted to the elderly and hospitalized population. Worldwide, the rate of prevalence of vitamin D deficiency has grown up rapidly in adults over the past decades. Among Libyan population including young students may has a high risk of vitamin D deficiency. The aims of this study were to examine vitamin D status among pharmacy students of Sebha University and to study the hematological profile as well as correlation of vitamin D deficiency with incidence of anemia among the students. This study was carried out on Pharmacy students from 13 th January to 12 th March, 2020. This is a cross-sectional study designed to determine vitamin D status among healthy young pharmacy students studying at the Sebha University. The blood samples were collected randomly from 62 pharmacy students to analysis complete blood count and 25-hydroxyvitamin D. The concentration of hemoglobin on total student was 12.5 ± 1.9 g/dl which was normal according to the WHO level (12.0 g/dl). Out of total, 36 students (59.1%) were found to have normal hemoglobin concentration (13.7 ± 1.4 g/dl) and 26 students (40.9 %) were found to have low hemoglobin concentration (10.8 ± 1.1 g/dl). Other blood profile as HCT, MCV, MHC and MCHC where statistically significant lower but the counts of RBCs, WBC and platelets were not on anemic group comparing to normal group. The present study reported that majority of pharmacy students in male and female blood donors have low vitamin D levels which represent (87.0%). Out of the total participants (n = 54) who have low vitamin D (n = 49, 79.0%) were classified under vitamin D deficiency category while (n = 05, 08.0%) of students had vitamin D insufficiency. In conclusion, prevalence of hypovitaminosis D (low 25-hydroxyvitamin D) among the pharmacy students at Sebha University was highly occurrence with concomitant a high rate of prevalence of anemia. Thus, vitamin D deficiency at this age represents a public health problem that should be addressed.
... They are frequently found in conjunction with acute and chronic clinical conditions. Various nonexperimental studies have established the association between vitamin D and anemia risk in healthy individuals and population with clinical conditions, as well as the critical role of vitamin D in iron homeostasis and process of erythropoiesis [2][3][4][5][6][7]. ...
... Numerous previous studies have established that low vitamin D levels are associated with an increased risk of childhood anemia and anemia in elderly adults, particularly in patients with chronic kidney disease and heart failure [4][5][6][7]. Previous studies [8,9] demonstrated that although vitamin D deficiency is more prevalent in African-Americans than in the white population, African-Americans have lower hemoglobin (Hb) concentrations than the white population. ...
... Various mechanisms have been suggested to explain the association of Vitamin D deficiency (VDD) with anemia. VDD leads to decreased calcitriol production in bone marrow and increased membrane permeability of calcium, resulting in impaired erythropoiesis 78,113 . VDD leads to hyperparathyroidism which raises proliferation of erythroid progenitor cells 114 . ...
Anemia is the most common nutritional disorder amongst Indian adolescents in India with 28% being afflicted. Despite the efforts, there has not been a significant reduction in the prevalence of anemia. The etiology of anemia is multifactorial and complex. Hence, there is a challenge to address the determinants of anemia in a population. In the present communication, the determinants of anemia such as nutritional factors, infectious diseases, genetic factors and other underlying factors has been reviewed. The pathophysiology, possible mechanisms and contribution of these factors in the etiology of anemia has been discussed. There is a need for analyzing the determinants of anemia amongst Indian adolescents for effective prevention and control of Anemia. Key words: Anemia, Iron deficiency, Hemoglobin, India, Adolescent.
... Vitamin D and iron levels were measured at the 25th and 40th weeks of gestation and the risk of IDA was found to be eight times higher in patients with vitamin D levels below 50 nmol/l [29]. Anemia that occurs in patients with vitamin D deficiency was previously attributed to the deficiency of erythropoietin production [30,31]. However, recent studies also emphasize the role of hepcidin, a hepatic peptide [32]. ...
Objectives: In recent years, many effects of vitamin D except on bone metabolism have been discovered. Vitamin D contributes to the correction of the anemia by acting on the erythroid precursors in the bone marrow via Vitamin D Receptor and provides the elimination of free radicals and prooxidant substances secondary to iron deficiency due to its antioxidant effect in iron deficiency anemia (IDA). Methods: A total of 97 female premenopausal women aged 18-44 were included in the study. Fifty patients with hemoglobin levels below 12 mg/dl and iron deficiency were classified as IDA group, and 47 subjects with hemoglobin levels of 12 mg/dl and above were classified as control group. The demographic data and biochemical parameters of all patients included in the study were analyzed. Results: The vitamin D of the patient group was found to be 7.87 ± 3.63 ng/ml and the vitamin D of the control group was 11.84 ± 6.72 ng/ml. The difference between the groups was statistically significant. There was a positive correlation between serum vitamin D and serum hemoglobin, hematocrit, serum MCH, serum iron level, transferrin saturation index, ferritin. Conclusions: In the light of the results of our study and other studies in the literature, we think that vitamin D deficiency may be important in patients with IDA and that vitamin D deficiency in these individuals will contribute to the regulation of anemia due to positive effects of vitamin D on both erythropoiesis and hepcidin in IDA are considered. However, larger studies are needed to clarify this issue.
... Given the negative results of previous clinical trials among healthy subjects and the inhibitory effects found in the present study, it appears that the role of vitamin D supplementation in improving iron stores may be limited to those with certain metabolic conditions, such as those with poor vascular and renal function [27,28]. Suboptimal levels of both vitamin D and iron are biomarkers of ill health, and the hypothetical association appears to be reciprocal, as clinical observations demonstrated the role of 1, 25(OH)D in erythropoiesis, and the participation of iron is essential in the second activation of vitamin D in order to be functional [29,30]. ...
Vitamin D deficiency has been shown to affect iron status via decreased calcitriol production, translating to decreased erythropoiesis. The present study aimed to determine for the first time whether vitamin D supplementation can affect iron levels among Arab adolescents. A total of 125 out of the initial 200 Saudi adolescents with vitamin D deficiency (serum 25(OH)D < 50 nmol/L) were selected from the Vitamin D-School Project of King Saud University in Riyadh, Saudi Arabia. Cluster randomization was done in schools, and students received either vitamin D tablets (1000 IU/day) (N = 53, mean age 14.1 ± 1.0 years) or vitamin D-fortified milk (40IU/200mL) (N = 72, mean age 14.8 ± 1.4 years). Both groups received nutritional counseling. Anthropometrics, glucose, lipids, iron indices, and 25(OH)D were measured at baseline and after six months. Within group analysis showed that post-intervention, serum 25(OH)D significantly increased by as much as 50%, and a parallel decrease of −42% (p-values <0.001 and 0.002, respectively) was observed in serum iron in the tablet group. These changes were not observed in the control group. Between-group analysis showed a clinically significant increase in serum 25(OH)D (p = 0.001) and decrease in iron (p < 0.001) in the tablet group. The present findings suggest a possible inhibitory role of vitamin D supplementation in the iron indices of healthy adolescents whose 25(OH)D levels are sub-optimal but not severely deficient, implying that the causal relationship between both micronutrients may be dependent on the severity of deficiency, type of iron disorder, and other vascular conditions that are known to affect hematologic indices. Well-designed, randomized trials are needed to confirm the present findings.
... The reported beneficial effect of VD-ST could be attributed to multiple mechanisms illustrating how VD can control iron homeostasis; where it was supposed that VDD induces local calcitriol production by bone marrow with concomitant increased membrane calcium permeability with susbsequent decline of erythropoiesis (40) . Later on these theoretical suggestions were approved experimentally to occur at mRNA and protein levels (41,42) . ...
... Multiple studies tried to investigate the relation between VDD and IDA, Zittermann et al. (29) supposed that VDD contributes to decreasing bone marrow local production of calcitriol with increasing calcium membrane permeability, so erythropoiesis declines. These changes as evidenced by In vitro studies occur at mRNA and protein (30) . ...
... 8,15 While there was some studies for an association between dificiency serum 25 (OH) D levels and anemia. 12 The previous studies were involved patients with chronic kidney disease (CKD), end-stage renal disease, 16 congestive heart failure 17,18 or diabetes 19 . The primary aim of our study was to investigate a significant correlation between 25 Hydroxyvitamin D and anemia parameters in eldery community of 60 years and older with anemia inflammation and non inflammation. ...
p> Background: Vitamin D deficiency and anemia are conditions commonly in eldery. Both result in significant morbidity in eldery. Relationship between 25-hydroxyvitamin D and anemia need to be concern, particularly in the elderly. including those characterized by inflammatory processes. The aim of this study is to analyze association and differentiations between of 25-hydroxyvitamin D levels and anemia parameters in elderly with anemia inflammation and non-inflammation.
Methods: An observational study, at Posyandu Lansia Puskesmas Sokaraja, was conducted among 40 subjects aged ≥60 years consecutively, between September - November 2015. 25-Hydroxyvitamin D, hemoglobin levels, hematocrit and red blood cell counts were measured. 25-Hydroxyvitamin D deficiency defined in level <30 ng/mL and anemia defined by the World Health Organization.
Results: After adjustment for CRP levels and leucocyte count, 25-Hydroxyvitamin D was inversely associated with anemia inflammation (p=0,018; p=0,010; p=0,000)and non-inflammation (p= 0,002; p=0,002; p=0,000). There was significantly differences 25-hydroxyvitamin D levels (p = 0.003) in elderly with anemia of inflammation and non-inflammation.
Conclusion: 25-Hydroxyvitamin D levels was associated with anemia inflammation and non-inflammation in eldery. Vitamin D may suppress inflammatory mechanism, and studies to determine whether chronic disease involves anemia inflamation are warranted.
Bangladesh Journal of Medical Science Vol.17(2) 2018 p.302-306</p
... Low vitamin D status, e.g., 25-hydroxyvitamin D (25OHD) levels <50 nmol/l, is also frequently seen in elderly patients [3]. Recent observational studies have indicated an association between vitamin D status and anemia risk in community-dwelling older people [4, 5], Asian children and adolescents [6] and different groups of patients [7][8][9][10][11]. There is, however, some evidence that the active vitamin D hormone 1,25-dihydroxyvitamin D (1,25[OH] 2 D) is a better predictor of anemia than circulating 25OHD [4, 7, 10] . ...
... Recent observational studies have indicated an association between vitamin D status and anemia risk in community-dwelling older people [4, 5], Asian children and adolescents [6] and different groups of patients [7][8][9][10][11]. There is, however, some evidence that the active vitamin D hormone 1,25-dihydroxyvitamin D (1,25[OH] 2 D) is a better predictor of anemia than circulating 25OHD [4, 7, 10] . In line with these data, first interventional studies in hemodialysis patients testing intravenous 1,25(OH) 2 D administration showed an increase in Hb levels, leading to improved control of anemia and reduced need for erythropoietin (EPO) [12, 13]. ...
... nmol/l), adequacy (50– 125 nmol/l) and potentially harmful (>125 nmol/l). Based on earlier classifications [7, 10], 1,25(OH) 2 D values were divided into three categories (<40 pmol/l; 40–70 pmol/l; >70 pmol/l). To assess the independent association of 25OHD and 1,25(OH) 2 D categories with anemia, we performed logistic regression analyses (unadjusted and multivariableadjusted ). ...
Purpose:
Anemia and vitamin D deficiency are both frequent in adult patients. Whether low vitamin D metabolite levels are an independent risk factor for different subtypes of anemia remains to be studied in detail.
Methods:
In 3299 patients referred for coronary angiography, we investigated the association of 25-hydroxyvitamin D (25OHD) and 1,25-dihydroxyvitamin D [1,25(OH)2D] with anemia [hemoglobin (Hb) <12.5 g/dl] of specific subtypes.
Results:
Compared with patients with 25OHD levels in the adequate range (50-125 nmol/l), patients with deficient 25OHD concentrations (<30 nmol/l; 33.6 % of patients) had 0.6 g/dl lower Hb levels. Hb values were 1.3 g/dl lower in patients with 1,25(OH)2D levels <40 pmol/l (5.4 % of patients), compared with patients in the highest 1,25(OH)2D category (>70 pmol/l). Of the participants, 16.7 % met the criteria for anemia. In multivariate-adjusted regression analyses, the odds ratios for anemia in the lowest 25OHD and 1,25(OH)2D categories were 1.52 (95 % CI 1.15-2.02) and 3.59 (95 % CI 2.33-5.52), compared with patients with 25OHD levels in the adequate range and patients with 1,25(OH)2D levels >70 pmol/l. The probability of anemia was highest in patients with combined 25OHD and 1,25(OH)2D deficiency [multivariable-adjusted odds ratio 5.11 (95 % CI 2.66-9.81)]. Patients with anemia of chronic kidney disease had the highest prevalence of 25OHD deficiency and 1,25(OH)2D concentrations of <40 pmol/l.
Conclusions:
Low 25OHD and 1,25(OH)2D concentrations are independently associated with anemia. Patients with poor kidney function are most affected. Interventional trials are warranted to prove whether administration of plain or activated vitamin D can prevent anemia.
