Vitamin D Status in Children with Thalassemia Major

Objective: To determine the vitamin D status in children with transfusion dependent beta thalassemia major attending outpatient department of Military hospital of Rawalpindi. Study Design: Cross sectional study. Place and Duration of Study: Outpatient Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Oct 2020. Methodology: All transfusion dependent beta-thalassemia major patients irrespective of age and sex were consecutively enrolled. Serum 25-hydroxy vitamin D3 (25(OH)D3) level was measured for the assessment of vitamin D status. Vitamin D sufficiency was defined as serum level of 25-OHD >30 ng/ml, vitamin D insufficiency was defined as serum 25-OHD 30-20 ng/ml, while vitamin D deficiency was defined as serum 25-OHD <20-10 ng/ml. Results: Of 162 children, 79(48.8%) were males and 83(51.2%) were females. The mean age was 5.8±2.63 years. Vitamin D deficiency was observed in 43(26.5%) patients, vitamin D insufficiency in 85(52.5%), while vitamin D sufficiency in 34(21.0%) patients with (p-value <0.352). A statistically significant association of vitamin D status was observed with regular use of vitamin D supplementation (p-value <0.001), calcium supplementation (p-value <0.001) and bone pains (p-value of <0.001). Type of iron chelation and serum ferritin level (p-value <0.001) were also found to be statistically significant. Association of vitamin D level with regular blood transfusion and frequency of blood transfusion was not found to be statistically significant (p-value<0.231). Conclusion: Children with beta thalassemia had a significant prevalence of vitamin D insufficiency, which contributes to bone damage.