Assessment of Serum Vitamin D, Ferritin and Bone Age in Children with Beta Thalassemia

Abstract

Background: Vitamin D deficiency is a common condition that occurs in children with beta thalassemia with a multifactorial aetiology. Excess iron in the liver, skin, parathyroid, and endocrine organs (pituitary) is studied as a cause of vitamin D deficiency in beta thalassemia patients. Literature showed that serum ferritin levels were significantly negatively correlated with vitamin D levels. Aims: The primary purpose of the study is to determine the correlation between vitamin D serum and delayed bone age with serum ferritin level in children with beta thalassemia. Study Design:  A cross-sectional study was conducted to evaluate the serum levels of vitamin D, ferritin, and bone age in children diagnosed with beta thalassemia. Place and Duration of Study: The study was conducted at the Pediatric Haematology and Oncology outpatient clinic and inpatient ward, Ulin General Hospital, Banjarmasin, South Kalimantan, Indonesia, between January 2024 and March 2024. Methodology: The study included 55 patients (34 male, 21 female; age range 2-18 years) with beta thalassemia, who underwent outpatient and inpatient treatment. Ferritin serum, 25-OH vitamin D level, and bone age were measured on the day of treatment. Bivariate analysis used the Spearman correlation test, with results considered significant if p<0.05. Results: Out of 55 patients, 50 patients (90,9%) experienced vitamin D insufficiency/deficiency and 15 patients (27.3%) experienced delayed bone age. There was a very weak and not significant correlation between serum ferritin level and serum vitamin D 25-OH level (r=-0.12; p=0.38), also between serum ferritin level and delayed bone age (r= 0.09; p=0.51). Conclusion: There is no correlation between serum ferritin level and vitamin D level, nor delayed bone age in children with beta thalassemia.