Correlation between 25-Hydroxyvitamin D and Lipid Profile among Children with Beta Thalassemia Major

Abstract

BACKGROUND:Beta thalassemia major is associated with lipid profile abnormalities, presented as a lower level of total cholesterol (TC), low-density lipoproteins (LDL), high-density lipoprotein (HDL), and higher triglyceride level; increasing risk for cardiovascular complications. The previous studies indicated that Vitamin D give a positive impact on the lipid profile in healthy children population. However, its role needs to be determined in a high-risk group of children with beta-thalassemia major.AIM:To determine the correlation between vitamin D (25-OHD) and lipid profile among children with beta-thalassemia major.METHODS:A cross-sectional study was conducted in a general tertiary hospital in Medan, Sumatera Utara, Indonesia from January to March 2018. Subjects were children aged below 18-year-old with beta-thalassemia major. The measurement of vitamin D (25-OHD) level and 10-12 hour overnight fasting serum lipid profile including total cholesterol, triglyceride, HDL, and LDL were performed. The analysis was done using Pearson’s correlation and Fisher test. P value < 0.05 was considered significant.RESULTS:Forty-five subjects were enrolled in this study, with serum ferritin level ranged from 1017 to 13372 ng/mL. The prevalence of vitamin D deficiency (a 25-OHD level less than 20 ng/mL) in this study was 40%, with mean value at 20.6 (SD 5.3) ng/mL. The markers for cardiovascular risk were observed to be elevated, both in Atherogenic Index Plasma (0.32 ± 0.25) and TC: HDL ratio (4.2 ± 1.5). Statistical analysis revealed that Vitamin D had positive correlation with total cholesterol (r = 0.302, p = 0.044) and HDL (r = 0.297, p = 0.048). There was no significant correlation between both vitamin D and triglyceride (p = 0.305), or vitamin D and LDL (p = 0.727).CONCLUSION:Vitamin D correlated positively with total cholesterol and HDL in children with beta-thalassemia major. Positive correlation to HDL indicated a beneficial effect of vitamin D to reduce the risk of cardiovascular complication.

The levels of 25-hydroxy vitamin D, parathyroid hormone, calcitonin and lipid profiles in patients with calcaneal spur

“…These results are consistent with previous studies. [ 32 , 33 ] These results indicate that a deterioration of both lipid metabolism and calcium homeostasis may occur due to 25(OH)D deficiency in patients with calcaneal spurs.…”

Nutrition in Thalassemia: A Systematic Review of Deficiency, Relations to Morbidity, and Supplementation Recommendations

“…Acting through various selenoproteins, selenium plays a vital role in thyroid hormone metabolism, DNA synthesis, and protection against free-radical damage. Serum selenium, as well as plasma activity of glutathione peroxidase, were commonly found to be lower in adult subjects with Thal compared with healthy controls, regardless of chelator type 48–50. Nasr et al51 also reported a negative relationship between selenium and serum ferritin in 64 transfusion-dependent Egyptian children with Thal.…”

“…Serum selenium, as well as plasma activity of glutathione peroxidase, were commonly found to be lower in adult subjects with Thal compared with healthy controls, regardless of chelator type. [48][49][50] Nasr et al 51 also reported a negative relationship between selenium and serum ferritin in 64 transfusiondependent Egyptian children with Thal.…”

“…40,41,44,47,56 Hepatic iron concentration is negatively correlated with 25(OH)D levels, 12,57,58 and serum ferritin is higher in vitamin D-deficient subjects. 47,56,59 Nasir et al 49 found that circulating 25(OH)D displayed a positive relationship with total cholesterol and high-density lipoproteins. Isik et al 60 found that 3 subjects with secondary hyperparathyroidism all had vitamin D deficiency.…”

Vitamin and Mineral Supplementation for β-Thalassemia During COVID-19 Pandemic

“…The fact that transfusion-dependent thalassemia was more prone to bacterial infection supports the alteration of immune function in this genetic disease [ 64 ]. The correlation of vitamin D deficiency in β-thalassemia has been known to alter the cardiovascular system [ 62 , 65 ], endocrines [ 66 ] and the bone [ 15 , 67 ]. A study involving all types of thalassemia, including β-thalassemia, supplementation of 50,000 IU of ergocalciferol (vitamin D 2 ) could increase the 25-OHD level; however, the effect of this supplementation on the immune system was not investigated [ 61 ].…”