The Effect of Vitamin D Deficiency on Anemia in Children and Adolescents: Meta-Analysis


  • Bani Dianika Master's Program in Public Health, Universitas Sebelas Maret
  • Yulia Lanti Retno Dewi Faculty of Medicine, Universitas Sebelas Maret
  • Bhisma Murti Master's Program in Public Health, Universitas Sebelas Maret



Background: Anemia in children and adolescents has an impact on central nervous system damage that can continue into adulthood. Some evidence states that one of the causes of anemia is vitamin D deficiency. This study aims to estimate the magnitude of the effect of vitamin D deficiency on the incidence of anemia in children and adolescents, through a meta-analysis of primary studies conducted by previous authors.

Subjects and Method: This study is a systematic review and meta-analysis with the following PICO, population: children and adolescents, intervention: vitamin D deficiency, comparison: no vitamin D deficiency, outcome: anemia. The articles used in this study were obtained from three databases, namely PubMed, Google Scholar, and Science Direct, using the search key "Vitamin D" OR "25-Hydroxy Vitamin D" OR "25(OH)D" AND "Anemia" OR " Anemia". The included article is a full-text cross-sectional study design from 2010 to 2022 and reports the adjusted odds ratio (aOR) in multivariate analysis. The selection of articles is done using PRISMA flow diagrams. Articles were analyzed using the Review Manager 5.4 application.

Results: A total of 9 cross-sectional studies involving 18,608 children and adolescents from the Americas and Asia were selected for meta-analysis. Children and adolescents with vitamin D deficiency had a risk of anemia 2.87 times compared to those without vitamin D deficiency (aOR= 2.87; 95% CI= 2.36 to 3.48; p<0.001).

Conclusion: Vitamin D deficiency increases the risk of anemia in children and adolescents.

Keywords: vitamin D deficiency, anemia, children, adolescents

Correspondence:Bani Dianika. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A Surakarta 57126, Central Java, Indonesia. Email: Mobile: +62852227­339349.


Alon DB, Chaimovitz C, Dvilansky A, Lugassy G, Douvdevani A, Shany S, et al. (2002). Novel role of 1,25(OH)(2)D(3) in induction of erythroid progenitor cell proliferation. Exp Hematol. 30:403-9.

Altemose KE, Kumar J, Portale AA, Warady BA, Furth SL, Fadrowski JJ, Atkinson MA (2018). Vitamin D insufficiency, hemoglobin, and anemia in children with chronic 33(11):2131-2136. doi: 10.1007/s004 6701840205.

Atkinson MA, Melamed ML, Kumar J, Roy CN, Miller ER 3rd, Furth SL, Fadrowski JJ (2013). Vitamin D, race, and risk for anemia in children. J Pediatr. 164(1):153-158.e1. doi: 10.1016/j.jpeds.2013.08.060.

Azizi-Soleiman F, Vafa M, Abiri B, Safavi M (2016). Effects of Iron on Vitamin D Metabolism: A Systematic Review. Int J Prev Med. 5;7:126. doi: 10.4103/20087802.195212.

Bikle D (2009). Nonclassic actions of vitamin D. J Clin Endocrinol Metab. 2009 94(1):26-34. doi: 10.1210/jc.20081454.

Carvalho C, Isakova T, Collerone G, Olbina G, Wolf M, Westerman M, et al. (2011). Hepcidin and disordered mineral metabolism in chronic kidney disease. Clin Nephrol. 76(2): 90-98.

Chang L, Liu X, Shi H, Dai W, Wang H, Jiang Y (2014). Association of 25 hydroxyvitamin D with Hb and lead in children: a Chinese population-based study. Public Health Nutr. 2014 17(4):827-32. doi: 10.1017/S13689800 13001675.

Jang H, Park S, Park K (2019). Association between vitamin D deficiency and anemia among Korean adolescent girls and young women. J Nutr Health.52(6), 552-558.

Kapil U, Kapil R, Gupta A (2019). Prevention and control of anemia amongst children and adolescents: theory and practice in India. Indian J. Pediatr. 86(6):523-531.

Kumar R, Sagar CS (2014). Iron Deficiency Anemia: a burden for world health. IJPHR, 1(1), 32-38. https://doi.or g/10.17511/ijphr.2014.i1.06.

Lee JA, Hwang JS, Hwang IT, Kim DH, Seo JH, Lim JS (2015). Low vitamin D levels are associated with both iron deficiency and anemia in children and adolescents. Pediatr Hematol Oncol. 32(2):99-108. doi: 10.3109/08880018.2014.983623.

Liu T, Zhong S, Liu L, Liu S, Li X, Zhou T, Zhang J (2015). Vitamin D deficiency and the risk of anemia: a meta-analysis of observational studies. Ren Fail. 37(6):929-34. doi: 10.3109/0886022X.2015.1052979.

Murti B (2018). Prinsip dan metode riset epidemiologi (Principles and methods of epidemiological research) (5th ed.). Program Studi Ilmu Kesehatan Masyarakat, Program Pascasarjana, Universitas Sebelas Maret.

Nikooyeh B, Neyestani TR (2018). Poor vitamin D status increases the risk of anemia in school children: National Food and Nutrition Surveillance. Nutrition. 47:69-74. doi: 10.1016/j.nut.2017.09.008.

Patel NM, Gutiérrez OM, Andress DL, Coyne DW, Levin A, Wolf M (2010). Vitamin D deficiency and anemia in early chronic kidney disease. Kidney Int. 77(8):715-20. doi: 10.1038/ki.2009.551.

Ruchala P, Nemeth E (2014). The pathophysiology and pharmacology of hepcidin. Trends Pharmacol Sci. 35(3):155-61. doi: 10.1016/

Sharma S, Jain R, Dabla PK (2015). The Role of 25-Hydroxy Vitamin D Deficiency in Iron Deficient Children of North India. Indian J Clin Biochem. 30(3):3137. doi: 10.1007/s122910140449x.

Sim JJ, Lac PT, Liu IL, Meguerditchian SO, Kumar VA, Kujubu DA, Rasgon SA (2010). Vitamin D deficiency and anemia: a cross-sectional study. Ann Hematol. 89(5):447-52. doi: 10.1007/s0027700908503.

Smith EM, Tangpricha V (2015). Vitamin D and anemia: insights into an emerging association. Curr Opin Endocrinol Diabetes Obes. 22(6):432-8. doi: 10.1097/MED.0000000000000199.

Syed S, Michalski ES, Tangpricha V, Chesdachai S, Kumar A, Prince J, Ziegler TR, Suchdev PS, Kugathasan S (2017). Vitamin D status is associated with hepcidin and hemoglobin concentrations in children with inflammatory bowel disease. Inflamm Bowel Dis. 23(9):1650-1658. doi: 10.1097/MIB.0000000000001178.

Wagner CL, Greer FR (2008). Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 122(5):1142-52. doi: 10.1542/peds.2008-1862. Erratum in: Pediatrics. 123(1):197.

WHO (2021). World Health Statistic 2021: Monitoring Health for The SDGs, Sustainable Development Goals. Geneva: WHO Pres. Yehuda S, Rabinovitz S, Carasso RL, Mostofsky DI (2009). The Effects of Brain Iron Deficiency on Cognitive and Behavioral Aspects. Rabinovitz S (ed): Iron Deficiency and Overload. Totowa: Humana Press.

Yehuda S, Rabinovitz S, Carasso RL, Mostofsky DI (2009). The Effects of Brain Iron Deficiency on Cognitive and Behavioral Aspects. Rabinovitz S (ed): Iron Deficiency and Overload. Totowa: Humana Press; p. 195–206

Yoon JW, Kim SW, Yoo EG, Kim MK (2012). Prevalence and risk factors for vitamin D deficiency in children with iron deficiency anemia. Korean J Pediatr. 55(6):206-11. doi: 10.3345/k jp.2012.55.6.206.




How to Cite

Dianika, B., Dewi, Y. L. R., & Murti, B. (2023). The Effect of Vitamin D Deficiency on Anemia in Children and Adolescents: Meta-Analysis . Journal of Maternal and Child Health, 8(1), 12–22.