scholarly journals Cobalamin and folate status in malnourished children

2017 ◽  
Vol 4 (4) ◽  
pp. 1480 ◽  
Author(s):  
Suresh Goyal ◽  
Kavita Tiwari ◽  
Pradeep Meena ◽  
Sunny Malviya ◽  
Mohd. Asif
Keyword(s):  
Vitamin B12 ◽  
Severe Acute Malnutrition ◽  
Vitamin B12 Deficiency ◽  
Folate Deficiency ◽  
Acute Malnutrition ◽  
Serum Folate ◽  
Plasma Vitamin ◽  
Folate Status ◽  
Malnourished Children ◽  
B12 Deficiency

Background: Vitamin B12 and folate are essential micronutrients which are critical especially during infancy and early childhood as these are periods of rapid growth, development, and increased demand. Malnutrition further increases the risk of these micronutrient deficiency due to poor socioeconomic status, inadequate intake and poor absorption. Aim of present work was to study the cobalamin and folate status in malnourished children.Methods: A hospital based observational study on 80 children suffering from severe acute malnutrition (SAM) aged 6-60 months. Detailed socio-economic, feeding and development history with complete anthropometric evaluation was done. Blood samples sent for measurement of plasma vitamin B12 and serum folate levels. Statistical analysis was done using SPSS version 20.0.Results: Mean age of SAM children was 17.25±12.60 months. 30 (37.5%) had vitamin B12 deficiency (vitamin B12 levels<100pg/ml) and 9 (11.25%) had borderline vitamin B12 levels (100-200pg/ml). Folate deficiency was found in only 7 (8.75%) children. Mean vitamin B12 and folate levels were found to be 353.65±330.76pg/ml, 11.18±4.17ng/ml respectively. Among vitamin B12 deficient children, majority (26, 86.66%) belong to lower socio-economic status, 17 (56.66%) were still predominantly on breast feeding and 11 (36.66%) had delayed introduction of complementary feeding. Among B12 deficient children 23 (76.66%) had delayed development (DQ <70). 100% of B12 deficient children were anemic with majority (21,70%) having severe anemia. 17 (56.66%) B12 deficient children also had associated thrombocytopenia (PC <1.5 lakh/cumm).Conclusions: There was a high prevalence of vitamin B12 deficiency among malnourished children. Folate deficiency was found only in few. Efforts should be directed to prevent its deficiency in pregnant and breastfeeding women and their infants with special attention on malnourished children.

scholarly journals Estimation of serum folate and vitamin B12 levels in children with severe acute malnutrition

2020 ◽  
Vol 7 (5) ◽  
pp. 1013
Author(s):  
Anjana Murthy K. ◽  
Ashwini Malladad ◽  
Mallesh Kariyappa
Keyword(s):  
Folic Acid ◽  
Vitamin B12 ◽  
Severe Acute Malnutrition ◽  
Folate Deficiency ◽  
Acute Malnutrition ◽  
Serum Folate ◽  
Folic Acid Deficiency ◽  
Plasma Vitamin ◽  
Age Group ◽  
Folate And Vitamin B12

Background: Severe acute malnutrition is the important health issue children affected in India. It is often associated with Iron, Vitamin B12 and Folic acid and other micronutrient deficiencies. These reports of declining trend of Iron and folic acid deficiency with implementation of national anemia control programme. Estimation of Serum Folate and Vitamin B12 levels in SAM children aged 6-60 months with anemia was the objective of the study.Methods: A hospital based observational study on 80 children admitted to nutritional rehabilitation center were suffering from severe acute malnutrition (SAM) in the age group of 6-60 months enrolled in the study during the period November 2018 to May 2019 .Data was collected using a predesigned and pretested Proforma, containing details of feeding, socio-economic and development history. Blood samples were sent for measurement of plasma vitamin B12 and serum folate levels. Statistical analysis was done using SPSS version 20.0.Results: Out of 80 children, majority were between the age group of 24-60 months and majority were boys (53.8%). Mean Vitamin B12 and folic acid levels being 384.61 and 8.95 respectively. 45% and 3.8% had vitamin B12 and folic acid deficiencies respectively. Majority of neurological changes and developmental delays were noted in B12 deficient group. Of the 36, B12 deficient children, majority had moderate anaemia (40.2%), normal total count (41.7%), 60% had neutropenia, 44.4% had lymphocytosis, majority had normocytic (30.9%) anemia.Conclusions: There was a moderate to high prevalence of vitamin B12 deficiency among malnourished children. Folate deficiency was found only in few. Efforts should be directed to prevent its deficiency in pregnant and breastfeeding women and their infants with special attention on malnourished children.B12 and folate deficiency shall be considered in all cases with SAM irrespective of blood indices. Treatment will have impact on prognosis of child.

scholarly journals Development delay in children with severe acute malnutrition and its association with Vitamin B12 deficiency

2019 ◽  
Vol 6 (6) ◽  
pp. 2484
Author(s):  
Aishvarya Adhualia ◽  
Manisha Maurya ◽  
A. D. Tewari
Keyword(s):  
Vitamin B12 ◽  
Developmental Delay ◽  
Complete Blood Count ◽  
Severe Acute Malnutrition ◽  
Megaloblastic Anemia ◽  
Macrocytic Anemia ◽  
Vitamin B12 Deficiency ◽  
Acute Malnutrition ◽  
Rehabilitation Centre ◽  
B12 Deficiency

Background: About half of the under five children are malnourished in India and so is morbidity associated with it. Malnutrition is also associated with multiple vitamin deficiency one of which is vitamin B12. Vitamin B12 is essential for DNA, RNA and protein synthesis; and for myelination of brain during the early childhood period. Deficiency of vitamin B12 can lead to megaloblastic anemia and neurological problems. So, authors aimed to look prevalence of vitamin B12 deficiency and; its hematological and neurological effects in severe acute malnourished children.Methods: it was an observational case control study, in which severe acute malnourished (SAM) children aged 0- 59 months who were admitted in Nutritional Rehabilitation Centre (NRC) were enrolled. Vitamin B12 levels were estimated and levels <200 pg/ml, 200-350 pg/ml, and >350 pg/ml were considered deficient, insufficiency and sufficient. Complete blood count was done for hematological effects and; developmental assessment was done to look for neurological effects.Results: Vitamin B12 was deficient, insufficient, normal in 15(16.3%), 25 (27.5%) and 52 (56.5%) children respectively. Vitamin B12 deficiency was significantly associated with hyperpigmentation and glossitis. Infant and young child feeding practices were not associated vitamin B12 deficiency. Macrocytic anemia was found in 23.4% SAM children and macrocytosis was not significantly associated with vitamin B12 deficiency.  Developmental delay was found in 55.3 % children and was not significantly associated with severe acute malnutrition. Conclusions: There is high prevalence of Vitamin B12 deficiency and insufficiency in children with severe acute malnourished children. Macrocytic anemia and developmental delay are not significantly associated with vitamin B12 deficiency.

Serum Folate of Less than 7.0 ng/mL is a Marker of Malnutrition

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S87-S87
Author(s):  
S N Mattox ◽  
D Kozman ◽  
G Singh
Keyword(s):  
Vitamin B12 ◽  
Clinical Laboratory ◽  
Tertiary Care ◽  
Vitamin B12 Deficiency ◽  
Folate Deficiency ◽  
Normal Serum ◽  
Serum Folate ◽  
Folate Supplementation ◽  
B12 Deficiency ◽  
The Difference

Abstract Introduction/Objective To identify clinical/laboratory factors associated with folate deficiency in tertiary care patients. Methods We reviewed the medical records of 1019 patients with serum folate &lt;7.0 ng/mL, 301 patients with serum folate of 15 ng/mL, and 300 patients with serum folate &gt; 23 ng/mL. Results Serum prealbumin levels were subnormal in 54.8% of patients with serum folate &lt;7.0 ng/mL. Vitamin B12, hemoglobin, and serum albumin levels were significantly lower in the &lt;7.0 ng/mL folate group. In 62.4% of patients with serum folate &lt;7.0 ng/mL, 1 or more markers of malnutrition were present. The low-folate group had a significantly higher prevalence of gastrointestinal (GI) disorders, sepsis, and abnormal serum creatinine level. There were no significant differences in the 2 groups regarding diabetes; behavioral/neurological disorders, including drug and alcohol abuse; bariatric surgery; or a diagnosis of malnutrition. The average body mass index (BMI) for the &lt;7.0 ng/mL and 15 ng/mL folate groups was significantly different (28.89 and 28.31, respectively), although the difference does not appear to be clinically meaningful. Conclusion The prevalence of folate deficiency depends on what is considered a normal serum folate level. Approximately 10% of tertiary care patients have levels &lt;7.0 ng/mL and exhibit other markers of malnutrition. It is recommended that patients with GI disorders, chronic kidney disease, and sepsis be routinely tested for serum folate levels, before administration of vitamin supplements. Patients with serum folate levels &lt;7.0 ng/mL should be evaluated for malnutrition, despite BMI &gt; 25. Folate supplementation should be administered only after excluding coexisting vitamin B12 deficiency.

scholarly journals Clinical profile of patients with infantile tremor syndrome in a tertiary care center

2020 ◽  
Vol 7 (11) ◽  
pp. 2172
Author(s):  
Gargi H. Pathak ◽  
Anuya V. Chauhan ◽  
Dhruti Pandya
Keyword(s):  
Vitamin B12 ◽  
Complementary Feeding ◽  
Severe Acute Malnutrition ◽  
Vitamin B12 Deficiency ◽  
Clinical Profile ◽  
Acute Malnutrition ◽  
Severe Anemia ◽  
Age Group ◽  
Nutritional Rehabilitation ◽  
B12 Deficiency

Background: Infantile tremor syndrome (ITS) is a condition reported from many areas of Indian subcontinent due to lack of proper nutrition, improper weaning or delayed introduction of complementary feeding. There is no proven macro or micro nutrient deficiency responsible for it but relation with vitamin B12 deficiency has been identified in some studies. The aim of this study was to study the clinical profile of patients with ITS.Methods: It is a prospective observational study including total 30 patients, from 6 months to 3-year age group, admitted to pediatric wards and nutritional rehabilitation centre, civil hospital, Ahmedabad, from June 2018 to December 2019.Results: Out of 30 patients studied, 69% had pre-ITS and rest had ITS, 61.5% were males and 38.4% were females, 69.2% had severe acute malnutrition, 84.6% had severe anemia and 23% of them presented with CCF, 15.4% patients had microcephaly and 23% had hypotonia. 23% had motor and speech delay. 61.5% belonged to lower socio-economic group. There was delayed introduction of complementary feeding in 63% of patients. 69% patients had severe vitamin B12 deficiency and 21% had moderate vitamin B12 deficiency.Conclusion: ITS, is commonly seen among male children belonging to lower socio-economic group among age group of 6 months to 24 months, presents with coarse tremors with moderate to severe anemia with moderate to severe acute malnutrition and is associated with deficiency of vitamin B12. Early diagnosis and treatment including nutritional rehabilitation grossly improved the outcome.

scholarly journals Serum folate, vitamin B12 levels and clinicohematological profile in 200 anaemic children aged 1-5 years

2018 ◽  
Vol 5 (6) ◽  
pp. 2167
Author(s):  
Sunita Arora ◽  
Pushpjeet Singh Sheemar ◽  
Mandeep Singh Khurana ◽  
Jaskiran Kaur ◽  
Ashwani Kumar
Keyword(s):  
Vitamin B12 ◽  
Tertiary Care ◽  
Vitamin B12 Deficiency ◽  
Folate Deficiency ◽  
Serum Folate ◽  
Age Group ◽  
Folate Supplementation ◽  
Total Prevalence ◽  
B12 Deficiency ◽  
Combined Deficiency

Background: This study was conducted in 200 anaemic children aged 1-5 years to check their serum folate, vitamin B12 levels and their correlation with sociodemographic parameters and clinicohaematological profile.Methods: Present study was a hospital based observational cross-sectional study carried out in paediatric OPD and IPD of tertiary care institute in Amritsar. Study subjects included 200 anaemic children aged 1-5 years attending paediatric OPD or admitted in IPD of paediatrics department of SGRDIMSAR, Amritsar. Serum folate, vitamin B12 levels were measured in 200 enrolled anaemic children and their correlation with sociodemographic parameters and clinicohaematological profile was studied.Results: Isolated vitamin B12 deficiency was present in 22 (11%), folate deficiency in 28 (14%) and combined deficiency was present in 10 (5%) cases. Isolated vitamin B12 deficiency was more prevalent in 1-2-year age group 10 (45.5%) cases, isolated folate deficiency in 2-3 years age group 12 (42.9%) cases whereas combined deficiency was more prevalent in 4-5 years age group 6 cases (60%). Statistically significant correlation was observed between severity of anaemia and poor socio-economic status, nutritional status, rural background. There was statistically significant association between vitamin B12 deficiency and poor socioeconomic status. Folate and combined deficiency had a positive correlation with age group. Combined vitamin B12 and folate deficiency had a statistically significant correlation with severity of anaemia.Conclusions: Apart from iron deficiency anaemia, vitamin B12 and folate deficiency contributes significantly in total prevalence of anaemia. Vitamin B12 and folate supplementation is equally important in prevention as well as treatment of nutritional deficiency anaemias in paediatric population.

scholarly journals Folate and Vitamin B12 Status in Women of Reproductive Age in Rural Areas in Haryana, Northern India (P10-117-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Reena Das ◽  
Mona Duggal ◽  
Manmeet Kaur ◽  
Hari Kishan Senee ◽  
Gursharan Singh Dhanjal ◽  
...  
Keyword(s):  
Vitamin B12 ◽  
Wheat Flour ◽  
Rural Areas ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Folate Deficiency ◽  
Reproductive Age ◽  
Serum Folate ◽  
Women Of Reproductive Age ◽  
B12 Deficiency

Abstract Objectives To conduct a household and biomarker survey to assess the baseline prevalence of folate deficiency and insufficiency and vitamin B12 deficiency in women of reproductive age prior to the start of a wheat flour fortification program in the Ambala District in Haryana, India. Methods A multistage cluster probability household and biomarker survey was conducted. Participants were women of reproductive age (18–49 y) who were not pregnant and resided in rural areas of two subdistricts in Ambala District in Haryana. Venous blood samples were collected among 866 women. Plasma, serum, and red blood cells (RBC) were separated by centrifugation, processed, and stored at <-80ºC until analysis. RBC and serum folate concentrations were measured using microbiologic assay and serum vitamin B12 was measured via chemiluminescence. Serum folate deficiency was defined as serum folate <7 nmol/L and RBC folate deficiency and insufficiency were defined as RBC folate <305 nmol/L and <748 nmol/L, respectively. Vitamin B12 deficiency was defined as vitamin B12 <200 pg/mL and vitamin B12 marginal deficiency was defined as vitamin B12 ≥200 and <300 pg/mL. Results The geometric mean concentrations for serum folate, RBC folate, and serum vitamin B12 were 12.3 (95% confidence interval [CI]: 11.8, 12.9) nmol/L, 544 (95% CI: 516, 573) nmol/L, and 190 (95% CI: 176, 206) pg/mL, respectively. The prevalence of folate deficiency was 11.3% (95% CI: 9.2, 13.9) for serum folate and 9.7% (95% CI: 7.8, 12.0) for RBC folate, and the prevalence of RBC folate insufficiency was 78.6% (95% CI: 74.8, 82.5). A total of 58.3% (95% CI: 54.2, 62.5) of women were vitamin B12 deficient (<200 pg/mL) and an additional 22.9% (95% CI: 19.7, 26.1) were marginally deficient for vitamin B12. Conclusions The magnitude of folate insufficiency and vitamin B12 deficiency in this Northern Indian population is a substantial public health concern. The findings from the survey help establish the baseline for a planned wheat flour fortification program aimed at reducing these micronutrient deficiencies. Funding Sources Centers for Disease Control and Prevention.

Serum Folate of Less than 7.0 ng/mL is a Marker of Malnutrition

2020 ◽  
Vol 51 (5) ◽  
pp. 507-511
Author(s):  
Diana Kozman ◽  
Samantha Mattox ◽  
Gurmukh Singh
Keyword(s):  
Vitamin B12 ◽  
Clinical Laboratory ◽  
Tertiary Care ◽  
Vitamin B12 Deficiency ◽  
Folate Deficiency ◽  
Normal Serum ◽  
Serum Folate ◽  
Folate Supplementation ◽  
B12 Deficiency ◽  
The Difference

Abstract Objective To identify clinical/laboratory factors associated with folate deficiency in tertiary care patients. Methods We reviewed the medical records of 1019 patients with serum folate &lt;7.0 ng/mL, 301 patients with serum folate of 15 ng/mL, and 300 patients with serum folate &gt; 23 ng/mL. Results Serum prealbumin levels were subnormal in 54.8% of patients with serum folate &lt;7.0 ng/mL. Vitamin B12, hemoglobin, and serum albumin levels were significantly lower in the &lt;7.0 ng/mL folate group. In 62.4% of patients with serum folate &lt;7.0 ng/mL, 1 or more markers of malnutrition were present. The low-folate group had a significantly higher prevalence of gastrointestinal (GI) disorders, sepsis, and abnormal serum creatinine level. There were no significant differences in the 2 groups regarding diabetes; behavioral/neurological disorders, including drug and alcohol abuse; bariatric surgery; or a diagnosis of malnutrition. The average body mass index (BMI) for the &lt;7.0 ng/mL and 15 ng/mL folate groups was significantly different (28.89 and 28.31, respectively), although the difference does not appear to be clinically meaningful. Conclusions The prevalence of folate deficiency depends on what is considered a normal serum folate level. Approximately 10% of tertiary-care patients have levels &lt;7.0 ng/mL and exhibit other markers of malnutrition. It is recommended that patients with GI disorders, chronic kidney disease, and sepsis be routinely tested for serum folate levels, before administration of vitamin supplements. Patients with serum folate levels &lt;7.0 ng/mL should be evaluated for malnutrition, despite BMI &gt; 25. Folate supplementation should be administered only after excluding coexisting vitamin B12 deficiency.

scholarly journals Clinico-epidemiology and assessment of folate and vitamin B12 status in severe acute malnourished children: a hospital-based observational study in the rural area of Uttar Pradesh

2021 ◽  
Author(s):  
Divya Verma ◽  
Sunil Kumar Singh ◽  
M. Ziauddin ◽  
Rinki Kumari
Keyword(s):  
Observational Study ◽  
Vitamin B12 ◽  
Severe Acute Malnutrition ◽  
Ferritin Level ◽  
Vitamin B12 Deficiency ◽  
Uttar Pradesh ◽  
Folate Deficiency ◽  
Vegetarian Diet ◽  
Acute Malnutrition ◽  
Folate And Vitamin B12

Background: Severe acute malnutrition (SAM) is a serious health problem in children in India. Vitamin B12 and folate are crucial micronutrients along with others required for rapid growth and development during infancy and early childhood, whereas their deficiencies contribute to malnutrition. The study aimed to evaluate iron, folate and vitamin B12 status in hospitalized SAM children aged between 6-59 months and their clinical, epidemiological profile.Methods: A hospital-based observational study on 159 children with SAM in the age group 6-59 months who were enrolled in the study based on anthropometric indicators after written informed consent from parents. The clinical, demographic profile and pertinent details of each patient were collected using standardized proforma and the blood samples were collected. Serum ferritin level was done in all anaemia cases, while vitamin B12 and folic acid (FA) were done only in children with macrocytic or dimorphic anaemia. For statistical analysis, SPSS 20.0 software was used.Results: Mean age of admitted children was 23.77±13.95 months belonging mainly to lower socioeconomic scale and joint families with preferential vegetarian diet. 39.62% SAM patients were between 6-12 months of age at the time of admission. The most common associated infections were GI infections (gastrointestinal tract) in 52.20%. Out of all cases, 93.71% of SAM patients were anaemic. 39.59% cases had macrocytic anaemia followed by microcytic anaemia in 30.20%. Of the 91 cases with macrocytic/dimorphic anaemia (based on MCV and morphology), vitamin B12 and FA levels were done, 92.30% and 61.53% had a deficiency of vitamin B12 and FA, respectively. Overall out of all admitted patients, 52.83% of SAM children had vitamin B12 deficiency and folate deficiency was found in 35.22% of children.Conclusions: SAM children had a high prevalence of vitamin B12 and folate deficiency. Efforts should be made to prevent deficiency of such micronutrients in pregnant and breastfeeding mothers and their infants. Treatment can affect a child's prognosis.

scholarly journals The prevalence of low serum levels of Vitamin D, Vitamin B12, folate and ferritin in adolescents: Single center experience

2021 ◽  
Vol 104 (2) ◽  
pp. 003685042110076
Author(s):  
Nazmi Mutlu Karakaş
Keyword(s):  
Vitamin D ◽  
Vitamin B12 ◽  
Medical Records ◽  
Vitamin B12 Deficiency ◽  
Serum Levels ◽  
Folate Deficiency ◽  
Well Child Care ◽  
Single Center Experience ◽  
B12 Deficiency ◽  
Prevalence Of Anemia

Background: In this study, the aim was to evaluate the prevalence of vitamin D, vitamin B12, ferritin, and folate deficiencies in adolescence to clarify the need for early diagnosis and therapy. Methods: The medical records of adolescents between 10 and 18 years of age between 01 September 2018 and 28 February 2019 as healthy with non-specific complaints, or due to well-child care visits, were analyzed retrospectively. Results: A total of 1847/2507 (73.6%) adolescents were included in the study. The prevalence of vitamin D deficiency was 25.7% (n: 178/691). Vitamin B12 deficiency prevalence was 69.2% (n: 753/1088). The prevalence of anemia and ferritin deficiency was 4.8% and 13.26%. The prevalence of folate deficiency was 37.9% (n: 413/1088). VDD prevalence was statistically significantly higher in females than males (F/M:116/62). VB12D prevalence, the number and mean age of females with hemoglobin deficiency, and low ferritin levels was found to be statistically significantly higher in females than males. Conclusions: The prevalence of vitamin D, vitamin B12, folate deficiency and low ferritin levels was found to be high among adolescents. In particular, adolescents admitting with non-specific complaints and for control purposes in big cities must be considered to be at risk for the deficiency of these vitamins and low level of ferritin.

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