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Open Journal of Hematology

ISSN: 2075-907X
Volume 8, 2017

Indexed in:

Open Journal of Hematology, 2015, 6-6 [Research Article]

Vitamin D Insufficiency and Liver Iron Concentration in Transfusion Dependent Hemoglobinopathies in British Columbia

Hatoon M. Ezzat1,3,*, John Wu2,3, Heather McCartney2,3, Heather A. Leitch1

1 Hematology, St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Canada
2 Hematology Oncology, BC Children’s Hospital, University of British Columbia, Vancouver, BC, Canada
3 Inherited Bleeding and Red Blood Cell Disorder Program of British Columbia, University of British Columbia, Vancouver, BC, Canada

Corresponding Author & Address:

Hatoon M. Ezzat*
Hematology Division, St. Paul’s Hospital, University of British Columbia, 490-1144 Burrard Street, Vancouver, BC V6Z 2A5, Canada; Phone: 604-684-5794; Fax: 604-684-5705; Email: hezzat@providencehematology.com

Article History:
Published: 8th June, 2015   Accepted: 8th June, 2015
Received: 16th March, 2015      

© Ezzat et al.; licensee Ross Science Publishers

ROSS Open Access articles will be distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided that the original work will always be cited properly.

Keywords: Thalassemia Major, Liver Iron Concentration, 25 hydroxyvitamin D, transfusional iron overload


Patients with thalassemia major (TM) and other chronically transfused hereditary anemias are at increased risk of complications including endocrinopathies and bone disease due to iron overload. Vitamin D is important for bone health. Vitamin D deficiency is common in patients with transfusional iron overload, and the mechanism remains unclear. The first step in vitamin D metabolism, hydroxylation, occurs in the liver and liver iron overload may interfere with this step. This study investigates an association between degree of liver iron overload and vitamin D levels in patients with transfusion dependent hemoglobinopathies. Patients with TM, hemoglobin Eβ TM (Eβ TM), and congenital dyserythropiotc anemia (CDA) attending the Inherited Bleeding and Red Blood Cell Disorder Program in British Columbia (IBRBCD BC), Canada were identified. Included patients had an assessment of liver iron concentration (LIC) by MRI and endocrinology assessment including 25 hydroxy vitamin D level. Thirty patients were identified. The mean LIC was 5.13 mg/g dry weight (DW). Vitamin D deficiency/insufficiency was identified in 19 (63.3%). Eleven (36.7%) patients had an LIC ≥5 mg/gDW, 8 of whom had a vitamin D level <60 nmol/L, indicating moderate vitamin D insufficiency or deficiency. There was a significant association between LIC >5 mg/gDW and vitamin D level <60nmol/L (P= 0.027) and there was a significant inverse correlation between LIC and vitamin D (R=-0.33). These results indicate an association between increased LIC and vitamin D insufficiency/deficiency, suggesting that liver iron overload may indeed affect vitamin D metabolism. Prospective trials are needed to confirm these results.

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