The evaluation of the prevalence of vitamin b12, folate, homocysteine and iron deficiency in school age children admitted to Zonguldak Bülent Ecevit University Medical School Hospital

Introduction and Purpose: Iron, vitamin B12 and folate deficiency are common micronutrient deficiencies all over the world especially in children. By inputing into many enzyme structures iron, vitamin B12 and folate have the roles of body metabolism, cellular division and differentiation, regulation of immune system, bone development, perception and intelligence functions. Their deficiency plays a role in maternal and infant mortality. In our study we wanted to determine the prevalance of serum iron, vitamin B12 and folate deficiency and their association with each other in 392 healthy children. When considering the effects due to the deficiencies this study was done in order to take necessary precautions not only for individual but also for community health. Material and Method: Serum iron level, iron binding capacity, ferritin, vitamin B12, folate, homosistein level and complete blood count were analysed in 392 healthy school-age children, between 6-14 ages consisting of 223 girls and 169 boys, who applied to Bülent Ecevit Medical Faculty, Pediatric Outpatient Clinic by taking the approval of their parents. In addition to the evaluation of the prevalence of the deficiencies of iron, vitamin B12 and folate, a survey study including various parameters such as socioeconomic status, nourishment habits, physical development and educational level was carried out. Findings: Our study was done with a total of 392 healthy children, 223 girls and 169 boys. %60,5 iron deficiency, %33,4 vitamin B12 deficiency and %7,6 folate deficiency and inadequacy was detected in those who participated in the study. There was no statistically significant difference between the iron and folate deficiency and gender and age. A statistically significant difference in adolescent incidence of vitamin B12 deficiency was recognized when the participants were examined in two groups of 6-10 ages (n= 211) and 11-14 ages (n= 181). There is no statistically significant difference with respect to vitamin B12 deficiency between the cases with iron deficiency and without iron deficiency (p>0,05). %10,2 folate deficiency and inadequacy was determined in those with iron deficiency whereas %3,9 folate deficiency and inadequacy was found in those without iron deficiency. This difference was determined as statistically significant (p=0,037). No statistically significant relation was found between the socioeconomic level and nourishment habit and the deficiency of iron and deficiency of iron anaemia. As the educational status increases, it is statistically meaningful that there is a decrease in vitamin B12 level (repectively p<0,001 and p=0,001). It's determined that vitamin B12 deficiency decreases as the consumption of red meat increases (p=0,006), as the consumption of vegetable increases, the folate deficiency decreases (p=0,017). A statistically significant relation was found between the iron deficiency and anorexia (p=0,046), amnesia (p=0,001), headache (p= 0,017), psyshiartic problems (p=0,013). A statistically significant difference was found between folate deficiency and paleness, weakness (p=0,008). A statistically significant relation was found between vitamin B12 deficiency and weight loss, weight gain problem (p= 0,038), headache (p=0,039). There was no statistically significant difference between age and gender and plasma homocysteine levels (p>0,05). Plasma homocysteine level was found to be statistically higher in participant with vitamin B12 deficiency (p=0,018). A statistically significant difference was found in terms of hyperhomocysteinemia when compared to insufficiency with normal vitamin B12 levels (p=0,041). Hyperhomocysteinemia was found in %33,3 of participant with folate deficiency and inadequacy and in %16,3 of participant with normal folate level, the difference was statistically significant (p=0,035). Discussion: Micronutrient deficiencies, not clinically significant, have many negative effects on human health. Nutritional deficiencies are often seen due to increased need for growth in children, unregulated nutrition habits and socioeconomic factors. These deficiencies cannot always come up with clinical complaints. Our aim should be to identify deficiencies before clinical symptoms occur. There has been many studies conducted on micronutrient deficiencies in developed countries. In our study, we found that deficiency of iron, vitamin B12 and folate is common in healthy children. There is a need for extensive research on prevalence of the problem and the preparation of programmes for solution.