Clinical Profile and Vitamin D Status in Beta Thalassemia Major Children at a Tertiary Care Institute of Central India: A Cross‑Sectional Study

Abstract

Background: In India, the prevalence of beta thalassemia is 3.74%, and sixty to eighty percent of thalassemic children have vitamin D  deficiency syndrome. 

Aim: To estimate the prevalence of vitamin D deficiency and parathyroid levels in thalassemic children of Central  India. 

Methods: This cross-sectional study was conducted on 61 diagnosed beta thalassemic children of 2-12 years of age at the pediatric  department of the tertiary care institute of Central India for six months by consecutive sampling method. Demographic, transfusion, and  clinical data were collected. Serum Vitamin D levels were estimated by electrochemical-luminescence technology and serum parathyroid  hormone was by immunoassay. Complete blood count, serum ferritin/calcium/phosphorous, and liver functions test were performed. Frequency, mean, standard deviation, and correlation of various variables were performed. 

Results: Three‑fourths of the participants  were above 5 years of age and male to female ratio was 1.5:1. Most (88.5%) cases required blood transfusion every 3–4 weeks duration  and 80.3% were receiving chelation therapy and all of them were on oral Deferasirox. About half of the participants had serum ferritin levels 1000–3000 ng/dl, and 27 (44.3%) had levels more than 3000‑ 5000 ng/ dl. The total mean vitamin D and parathyroid hormone were  18.4 ± 9.9 ng/ml, and 13.1 ± 15.4 pg/ml respectively. The prevalence of low vitamin D was 63.9% and low parathyroid level in 21.3% of  participants. Serum vitamin D level was inversely related to age, serum ferritin level, and transfusion frequency while directly related to  serum calcium level. 

Conclusion: The prevalence of vitamin D deficiency is 63.9% and low parathyroid hormone is 21.3%. Serum vitamin D  has a negative correlation with increased age and increased serum ferritin levels.