Assessment of Vitamin D3 and Iron Status and their correlation among Libyan Children at a Tertiary Care Centre in East Libya

Background: Recent studies have suggested a relationship between serum vitamin D (25-hydroxyvitamin) and iron. Vitamin D regulates iron through hepcidin, an iron regulatory hormone; on the other hand, iron controls vitamin D metabolism. Nevertheless, vitamin D and iron deficiency are highly prevalent worldwide. We have no data on their interactions among our Libyan children.  Aim: To assess the correlation (association)between 25-hydroxyvitamin D (25(OH)D) and iron status and evaluate the frequency(prevalence) of iron deficiency anemia (IDA) and vitamin D deficiency (VDD) in our study group. Method: An observational descriptive study of 94 Libyan children (1-14 years) diagnosed with iron deficiency (low serum ferritin). The following data were collected from a medical record: age, sex, and laboratory data, including Hemoglobin (Hb), serum ferritin, and vitamin D levels. All our cases were classified according to hemoglobin level in each specific age group into iron deficiency (ID) and iron deficiency anemia (IDA). The study population will then be categorized into vitamin D deficiency (VDD), vitamin insufficiency (VDI), and vitamin D sufficiency (VDS) based on the cutoff vitamin D values. Statistical analysis: Data entered in SPSS 23rd version. Descriptive statistics were used for numerical variables. Spearman’s rho correlation and the Kruskal-Wallis test were used to estimate the correlation between vitamin D3 with serum ferritin levels and between vitamin D level and iron deficiency anemia of study participants. Results: Of the total 94 studied iron-deficient children, 50% of the study group were males, and 53% of the study children were aged 1-5 years. The mean age was 6.45 years with a standard deviation of 4.2. The mean serum ferritin is 7.55 and the mean vitamin D is 21.78. Sixty-seven percent (67%) of them exhibited iron deficiency anemia (IDA), Additionally, 53% and 24% of the subjects had vitamin D deficiency and vitamin D insufficiency, respectively. However, approximately 51% of the children had concurrent low serum ferritin and vitamin D deficiency. The Spearman’s rho correlation showed a statistically significant correlation between Vitamin D3 and ferritin (p-value of 0.002). In addition, the nonparametric Kruskal-Wallis test also reveals a significant association between them (p = 0.039). Conclusion: The result of our study showed a high prevalence (51%) of concurrent low ferritin and vitamin D status. In addition to a strongly positive significant correlation between vitamin D and ferritin According to WHO-definitions of iron deficiency anemia (IDA). IDA in our study children is considered a severe public health problem in Libyan children in addition to it is association with low vitamin D status. So we need further studies to explain the causal and risk factors as well as their relationship mechanism.