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. 2017 May 4:8:41-48.
doi: 10.1016/j.jcte.2017.05.001. eCollection 2017 Jun.

Serum 25-hydroxyvitamin D but not dietary vitamin D intake is associated with hemoglobin in women of reproductive age in rural northern Vietnam

Ellen S Michalski  1 , Phuong H Nguyen  2   3 , Ines Gonzalez-Casanova  4 , Son V Nguyen  2 , Reynaldo Martorell  1   4 , Vin Tangpricha  1   5 , Usha Ramakrishnan  1   4
Affiliations

Serum 25-hydroxyvitamin D but not dietary vitamin D intake is associated with hemoglobin in women of reproductive age in rural northern Vietnam

Ellen S Michalski et al. J Clin Transl Endocrinol. .

Abstract

Background and objectives: Hypovitaminosis D and anemia are both prevalent in Vietnam, and low vitamin D status may be a risk factor for anemia. This study aimed to 1) describe vitamin D intake and its determinants, and 2) examine the associations of vitamin D intake and serum 25(OH)D concentrations with hemoglobin and anemia.

Methods and study design: We used data from the baseline survey of a pre-conceptual micronutrient supplementation trial in women of reproductive age (WRA) in Thai Nguyen, Vietnam (N = 4961). Vitamin D intake was estimated using a semi-quantitative food frequency questionnaire (FFQ). Multivariable regression models were used for the analyses.

Results: Median vitamin D intake was 0.2 µg/d (8.0 IU) [IQR: 0.4]. Age, being a farmer, food insecurity, and body mass index (BMI) were inversely associated with vitamin D intake, while socioeconomic status (SES), total energy intake, and education were positively associated with vitamin D intake. Vitamin D intake was not associated with hemoglobin concentration or anemia after adjusting for age, BMI, total energy intake, transferrin receptor, C-reactive protein, α1-acid glycoprotein, SES, occupation, education, ethnicity, and food insecurity (P = 0.56 and P = 0.65 for hemoglobin and anemia, respectively). Controlling for the same covariates, 25(OH)D <50 nmol/L (vs. ≥50 nmol/L) was associated with decreased hemoglobin concentrations (β = -0.91 (SE:0.42), P = 0.03), but not with anemia (P = 0.11).

Conclusions: Low vitamin D status may be linked to reduced hemoglobin concentrations, but the role of diet in this association was not evident in this population of WRA in Vietnam where dietary vitamin D intake was very low.

Keywords: 25(OH)D, 25-hydroxyvitamin D; AGP, α1-acid glycoprotein; AMDR, acceptable macronutrient distribution range; Anemia; CRP, C-reactive protein; Dietary intake; EAR, estimated average requirement; Hemoglobin; IOM, Institute of Medicine; IQR, interquartile range; RBP, retinol binding protein; SD, standard deviation; SE, standard error; SES, socioeconomic status; Vietnam; Vitamin D; WHO, World Health Organization; WRA, women of reproductive age; sTfR, soluble transferrin receptor.

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Figures

Fig. 1
Fig. 1
Distribution of dietary vitamin D intake among women of reproductive age in northern Vietnam (n = 4961).
See this image and copyright information in PMC

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