Vitamin D and vitamin B12 status in children with complicated severe acute malnutrition

Abstract

Background: Severe acute malnutrition (SAM) is a major public health challenge frequently accompanied by hidden micronutrient deficiencies. This study evaluated the prevalence of vitamin D and vitamin B12 deficiencies and their clinical associations among children hospitalized with complicated SAM. Methods: A hospital-based cross-sectional study was conducted among 100 children (aged 6–59 months) admitted with complicated SAM at a tertiary care center in eastern Uttar Pradesh. Anthropometric data, clinical complications and feeding practices were documented. Serum 25-hydroxy vitamin D and vitamin B12 levels were quantified using standardized assays. Results: The cohort (mean age: 33.2±15.6 months; 58% male) exhibited frequent complications, including pallor (72%), convulsions (62%), pneumonia (58%) and acute gastroenteritis (56%). Vitamin D deficiency (<20 ng/ml) was present in 62% of children and vitamin B12 deficiency (<200 pg/ml) was found in 54%. Notably, 38% of the patients exhibited concurrent deficiencies of both micronutrients. Despite these significant overlapping nutritional deficits, standard inpatient nutritional rehabilitation yielded robust clinical recovery rates that were comparable across isolated vitamin D deficiency (83.9%), isolated vitamin B12 deficiency (88.9%) and combined deficiency (86.8%) groups. Conclusions: Vitamin D and vitamin B12 deficiencies are highly prevalent and frequently coexist among children with complicated SAM. While standard inpatient rehabilitation remains highly effective across all deficiency subgroups, routine micronutrient screening and targeted supplementation should be integrated into SAM management protocols to optimize overall recovery and mitigate long-term health consequences.