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Prevalence and Predictors of Vitamin B12 Deficiency in Children with Severe Acute Malnutrition, and its Association with Development

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Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objectives

To determine the proportion of children with severe acute malnutrition (SAM) having vitamin B12 deficiency, its clinical predictors, and its association with development.

Methods

In this cross-sectional study, 100 children between 1 mo to 59 mo [mean (SD) age 17 (12.75) mo; 55 males], with diagnosis of SAM as per WHO criteria, were included. Serum vitamin B12, serum folate, and serum ferritin levels were measured by chemiluminescence immunometric assay method, while serum Homocysteine (Hcy) level was measured by enzymatic cycling method. Development assessment was done by Denver Development Screening Tool (DDST-II).

Results

The mean (SD) serum vitamin B12 (cobalamin) levels were 296.52 (246.95) pg/mL; 45% children were vitamin B12 deficient (<203 pg/mL). Hyperhomocysteinemia (>14 µmol/L) was present in 39 (39%), and among these 69% (27/39) children had concomitant low serum vitamin B12 levels. Severe anemia and hypoproteinemia were significantly and independently associated with vitamin B12 deficiency [aOR (95% CI) 3.22 (1.13, 10) and 10 (1.66, 58.82), respectively]. Out of 45 children who were vitamin B12 deficient, 93%, 87%, 62% and 80% had gross motor, fine-motor, language and adaptive-cognitive delay, respectively. Vitamin B12 level was significantly associated (P <0.001) with developmental delay.

Conclusions

There is a high prevalence of vitamin B12 deficiency in children with SAM, which is also associated with development delay across all domains (except language) in these children.

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Funding

This study was supported by Intra-Mural Research Grant of University College of Medical Sciences.

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Authors and Affiliations

  1. Department of Pediatrics, University College of Medical Sciences (University of Delhi) & Associated Guru Teg Bahadur Hospital, Dilshad Garden, New Delhi, 110095, India

    Aliya Atiq, Dheeraj Shah, Rajesh Kumar Meena & Piyush Gupta

  2. National Institute of Health & Family Welfare, New Delhi, India

    Dheeraj Shah

  3. Department of Biochemistry, Chacha Nehru Bal Chikitsalaya, Delhi, India

    Shikha Sharma

  4. Department of Pediatrics, Genetic Unit and Laboratory, Maulana Azad Medical College (University of Delhi) and associated Lok Nayak Hospital, Delhi, India

    Seema Kapoor

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  1. Aliya Atiq
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  2. Dheeraj Shah
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  4. Rajesh Kumar Meena
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  6. Piyush Gupta
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Contributions

DS, PG: Study conceptualization; AA: Data collection & writing the initial draft of manuscript; SS, SK: Laboratory assessment, data analysis and its interpretation; DS: Supervised data collection, statistical analysis and interpretation; RKM: Statistical analysis and interpretation, manuscript writing, review and editing; SK, PG: Critical inputs to manuscript writing. All authors approved the final version of the manuscript. DS will act as guarantor for this manuscript.

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Correspondence to Dheeraj Shah.

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Atiq, A., Shah, D., Sharma, S. et al. Prevalence and Predictors of Vitamin B12 Deficiency in Children with Severe Acute Malnutrition, and its Association with Development. Indian J Pediatr (2023). https://doi.org/10.1007/s12098-023-04909-x

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