Vitamin D, Vitamin B12 and Ferritin Levels in Children Presenting with Malnutrition Complaints

Öz

Aim: In this study, it is aimed to examine the levels of [25(OH)D], vitamin B12 and ferritin, which we think are associated with the disease, in children who apply with the complaint of protein and energy deficiency. Material and Method: The [25(OH)D] level of 1377 people who applied to the hospital, the vitamin B12 level of 1366 people and the ferritin level of 1384 people who applied to the hospital were included in the study. Hospital references for children were used for vitamin D [25(OH)D], vitamin B12 and Ferritin levels. Results: When [25(OH)D] levels were examined in the study; Approximately 27% of the children had vitamin D deficiency [25(OH)D] <20 ng/mL, 7.19% had excessive [25(OH)D] deficiency and 6.68% had a high level of vitamin D deficiency. When vitamin B12 levels were examined, Vitamin B12 levels were low in 5.2% of the children (B12<191 ng/L) and high in 14.35%. Considering the ferritin levels, ferritin levels were low in 49.35% of children (ferritin level <30 μg/L). Conclusion: It was observed that B12, [25(OH)D] and ferritin levels of patients with PEM could vary according to geographical regions. For this reason, we think it is necessary to focus on the age range of 6–24 months, where the incidence of micronutrient deficiencies and infectious diseases is the highest.

Anahtar Kelimeler

• PEM
• child
• vitamin D
• vitamin B12; ferritin

Kaynakça

1. 1. Kumar S, Olson DL, Schwenk WF. Part I. Malnutrition in the pediatric population. Dis Mon. 2002;48(11):703–12.
2. 2. Kuwornu J, Amoyaw J, Manyanga T, Cooper E, Donkoh, E, Nkrumah A. Measuring the overall burden of early childhood malnutrition in Ghana: A comparison of estimates from multiple data sources. Int J Health Policy Manag. 2022;11(7):1035–46.
3. 3. Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al.; Maternal and Child Undernutrition Study Group. Maternal and child undernutrition: global and reigonal exposures and health consequences. Lancet. 2008;371(9608):243–60.
4. 4. Das JK, Lassi ZS, Hoodbhoy Z, Salam RA. Nutrition for the Next Generation: Older Children and Adolescents. Ann Nutr Metab. 2018;72(3):56–64.
5. 5. Valdés-Sosa PA, Galler JR, Bryce CP, Rabinowitz AG, BringasVega ML, Hernández-Mesa N, et al. Seeking biomarkers of early childhood malnutrition’s long-term effects. MEDICC Rev. 2018;20(2):43–8.
6. 6. Holick MF, Chen TC. Vitamin D deficiency: A world wide problem with health consequences. Am J Clin Nutr. 2008;87(4):1080–6.
7. 7. Abrams SA. Nutritional rickets: an old disease returns. Nutr Rev. 2002;60(4):111–15.
8. 8. Pelin Z, Şit U, Fatma NÖ, Atilla Çİ, Neşe Y. Hiperpigmentasyon ile başvuran bir vitamin B12 eksikliği olgusu. Yeni Tıp Derg. 2007;24(4):234–6.

9. 9. Kalantar-Zadeh K, Rodriguez RA, Humphreys M H. Association between serum ferritin and measures of inflammation, nutrition and iron in haemodialysis patients. Nephrol Dial Transplant. 2004;19(1):141–9.
10. 10. Bai P, Rais H, Fawad B, Kumari S. Concordance Between Indices of Malnutrition: Mid-upper arm circumference V/S weight for the height Z score in different age groups in Karachi, Pakistan. Cureus. 2022;14(7):e27387.
11. 11. Vaid A, Sharma M, Jamunashree B, Gautam P. Serum vitamin B12 levels in severe acute malnutrition hospitalized children between age group 6 months to 59 months in Kangra, India. Int J Contemp Pediatr. 2018; 5(5):1997–1.
12. 12. Neyzi O. Beslenme ve beslenme bozuklukları. İçinde: Günay S (yazar). Pediyatri. İstanbul Nobel Tıp Kitapevleri Ltd Şti. 2010. ss. 239–51.
13. 13. Chandra RK. Protein-energy malnutrition and immunological responses. J Nutr. 1992;122(3):597–600.
14. 14. Türkiye Nüfus ve Sağlık Araşltırması 1993. Ankara: Sağlık Bakanlığı (Türkiye), Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü ve Macro International Inc.; 1994. ss. 113–25.
15. 15. Stidham GL. Emergencies in international child health. Curr Opin Pediatr. 1997;9(3):254–8.
16. 16. Neyzi O. Çocukluk yaşlarında beslenme durumunun değerlendirilmesi. Ed: İlter Ö, Arısoy N, Aydın A. 2000’e 5 kala Türkiye ve Dünya çocuklarının durumu. XXXI. Türk Pediatri Kongresi Kitabı; 1995. ss. 25–30.
17. 17. Rowland MG, Rowland SG, Cole TJ. Impact of infection on the growth of children from 0 to 2 years in an urban West African community. Am J Clin Nutr. 1988;47(1):134–8.
18. 18. Nyaradi A, Li J, Hickling S, Foster J, Oddy WH. The role of nutrition in children’s neurocognitive development, from pregnancy through childhood. Front Hum Neurosci. 2013;7:97.
19. 19. Dündar N, Dündar B. Malnütrisyonlu çocuğun değerlendirilmesi. SDÜ Tıp Fakültesi Derg. 2009;13(4):39–42.
20. 20. Walli NZ, Munubhi EK, Aboud S, Manji KP. Vitamin D levels in malnourished children under 5 years in a tertiary care center at Muhimbili National Hospital, Dar es Salaam, Tanzania –a cross-sectional study. J Trop Pediatr. 2017;63(3):203–9.
21. 21. Ejaz MS, Latif N. Stunting and micronutrient deficiencies in malnourished children. J Pak Med Assoc. 2010;60(7):543–7.
22. 22. Food and Agriculture Organization of The United Nations. The state of food insecurity in the World 2014: strengthening the enabling environment for food security and nutrition. Food and Agriculture Organization of the United Nations, Rome; 2015.
23. 23. Anwer J, Mustafa G, Khalid S, Younis S, ul Haq R, Tayyab HM. Vitamin B 12 and folic acid deficiency among malnourished children with pancytopenia. Professional Med. 2020;27(2):348–52.
24. 24. Ng’eno BN, Perrine CG, Whitehead RD, Subedi GR, Mebrahtu S, Dahal P, et al. High prevalence of vitamin B12 deficiency and no folate deficiency in young children in Nepal. Nutrients. 2017;9(1):72.
25. 25. Karagöl C, Yiğit M. Evaluation of clinical and laboratory findings and diagnostic difficulties in children with vitamin B12 deficiency. Pediatr Pract Res. 2022;10(1):1–5.
26. 26. Çolak A, Akşit MZ, Şimşek N, Bilgi P, Anıl M. Iron, folate and vitamin B12 status of children and adolescents: single center study in the Aegean region. J Dr. Behcet Uz Children’s Hospital. 2019;9(3):183–90.
27. 27. Şensoy F, Egemen A, Akgün B, Boztok D. Çubuk bölgesinde 0–48 aylık çocuklarda malnütrisyon prevalansı Beslenme ve Diyet Derg. 1991;20(1):9–19.
28. 28. Wong AY, Chan EW, Chui CS, Sutcliffe AG, Wong IC. The phenomenon of micronutrient deficiency among children in China: a systematic review of the literature. Public Health Nutr. 2014;17(11):2605–18.
29. 29. Vaid A, Sharma M, Jamunashree B, Gautam P. Serum vitamin B12 levels in severe acute malnutrition hospitalized children between age group 6 months to 59 months in Kangra, India. Int J Contemp Pediatr. 2018;5(5):1997–2001.
30. 30. Palacios C, Gonzalez L. Is vitamin D deficiency a major global public health problem? J Steroid Biochem Mol Biol. 2014;144:138–45.
31. 31. Wickramasinghe SN, Gill DS, Broom GN, Limited value of serum ferritin in evaluating iron status in children with proteinenergy malnutrition. Scand J Haematol. 1985;35(3):292–8.
32. 32. Saka A, Ojuawo AI, Saka MJ, Biliaminu SA, Olatunbosun L. Assessment of iron deficiency in malnutrition: the value of serum ferritin. Tanta Med J. 2019;47(1):39–44.
33. 33. Wang J, Wang H, Chang S, Zhao L, Fu P, Yu W, et al. The influence of malnutrition and micronutrient status on anemic risk in children under 3 years old in poor areas in China. PLoS One. 2015;10(10):e0140840.