Vitamin B12 status among anaemic adolescents

Amita Surana, Sandeep Tilwani, Shefali Patel, Hiren Prajapati, Rajeev Prasad


Background: Nutritional anaemia are common health problems. Most studies are done regarding iron deficiency anaemias. There are limited data regarding vitamin B12 deficiency anaemia especially in adolescents. Aims and objectives of the study were to find the prevalence of vitamin B12 deficiency among anaemic adolescents and to study various socio-demographic factors and hematological parameters associated with vitamin B12 deficiency.

Methods: Cross sectional hospital based observational study of 211 adolescents (10 -18 year) with anaemia. Socio demographic characteristics like age, sex, education of mother & patient, socio- economic class, dietary history were noted for each patient. CBC including RBC indices and serum estimation of vitamin B12 level were done for each patient.

Results: Anaemia was seen in 46.6% of adolescents. Vitamin B12 deficiency was seen in 49.76%. Vitamin B12 deficiency was significantly associated with male gender (p=0.032) and vegetarians (p=0.047). Moderate to severe degree of anaemia (p=0.016), macrocytosis (p= 0.000) and thrombocytopenia (p=0.007) was more observed in vitamin B12 deficient patients as compared to vitamin B12 non deficient groups. Statistically significant fall in mean haemoglobin level and increase in mean MCV values were seen with decreasing serum vitamin B12 level.

Conclusions: Among anemic male and vegetarian adolescents vitamin B12 deficiency is a significant health problem. Hematological findings in peripheral blood are more associated with severe degree of vitamin B12 deficiency. Vitamin B12 supplementation along with IFA should be addressed through national programmes.



Adolescent, Anaemia, Hematological changes, Sociodemographic factor, Vitamin B12 deficiency

Full Text:



Saratha A, Singh Z, Datta SS, Boratne AV, Senthilvel V, Joice S. Prevalence of Anaemia among Young Adult Female Students in Medical teaching Institution in Pondicherry. Indian J Maternal Child Health. 2010;12(4):1-8.

Basu S, Hazarika R, Parmar V. Prevalence of Anaemia among School going Adolescents of Chandigarh. Indian Pediatr. 2007;42:593.

Premalatha T, Valarmathi S, Srijayanth P, Sundar JS, Kalpana S. Prevalence of Anaemia and associated Factors among Adolescent School Girls in Chennai, Tamil Nadu, India. Epidemiol. 2012;2:118.

Dugdale M. Anaemia. Obstet Gynecol Clin North Am. 2001;28(2):363-81.

Bhardwaj A, Kumar D, Raina SK, Bansal P, Bhushan S, Chander V. Rapid Assessment for Coexistence of Vitamin B12 and Iron Deficiency Anaemia among Adolescent Males and Females in Northern Himalayan State of India. Anaemia. 2013;2013:959605.

Fishman SM, Christian P, West KP. The Role of Vitamins in the Prevention and Control of Anaemia. Public Health Nutrition. 2000;3(2):125 -50.

Stabler S. Vitamin B12 Deficiency. N Engl J Med. 2013;368:149-60.

Molloy AM, Kirke PN, Brody LC, Scott JM, Mills JL. Effects of Folate and Vitamin B12 Deficiencies during Pregnancy on Fetal, Infant and Child Development. Food Nutr Bull. 2008;29(2):101-11.

Atay E, Akin M, Ozman B, Oztekin O, Karakus YT, Erdogan F. Frequency of Hematological Findings Associated with Severe Plasma Vitamin B12 deficiency in Infants and Adolescents. Clin Lab. 2014;60:659-62.

Kanani S. Combating Anaemia in Adolescent Girls: a report from India. Mothers Child. 1994;13:1-3.

Kumar S, Raharatam A. Prevalence of Anaemia and Hookworm infestation among Adolescent girls in one rural block of Tamilnadu. Indian J matern Child Health. 1997;8:73-5.

Muzammil K, Kishore, Semwal J. Common Nutritional deficiencies of Adolescents in Dehradun. Indian J Sci Res. 2010;1(1):77-80.

Villamor E, Mora-Plazas M, Forero Y, Lopez-Arana S, Baylin A. Vitamin B12 Status is Associated with Socioeconomic Level and Adherence to an Animal Food Dietary Pattern in Colombian School Children. J Nutr. 2008;138(7):1391-8.

Taneja S, Bhandari N, Strand TA, Sommerfelt H, Refsum H, Ueland PM, et al. Cobalamin and folate status in infants and young children in a low-to-middle income community in India. Am J Clin Nutr. 2007;86:1302–9.

Refsum H, Yajnik CS, Gadkari M, Schneede J, Vollset SE, Orning L, et al. Hyperhomocysteinemia and elevated methylmalonic acid indicate a high prevalence of cobalamin deficiency in Asian Indians. Am J Clin Nutr. 2001;74:233–41.

Thomas D, Chandra J, Sharma S, Jain A, Pemde KH. Determinants of Nutritional Anaemia in Adolescents. Indian Pediatr. 2015;52;867-69.

Koc A, Kocyigit A, Soran M, Demir N, Sevinc E, Erel O, et al. High Frequency of Maternal Vitamin B12 deficiency as an Important Cause of Infantile Vitamin B12 Deficiency in Sanlinurfa Province of Turkey. Eur J Nutr. 2006;45:291-7.

Isik Balci Y, Karabulut A, Gurses D, Ethem Covut I. Prevalence and Risk Factors of Anaemia among Adolescents in Denizli, Turkey. Iran J Pediatr 2012;22:77-81.

Allen LH. Folate and vitamin B12 status in the Americas. Nutr Rev. 2004;62:29–33.

McLean ED, Allen LH, Neumann CG, Peerson JM, Siekmann JH, Murphy SP, et al. Low plasma vitamin B-12 in Kenyan school children is highly prevalent and improved by supplemental animal source foods. J Nutr. 2007;137:676–82.

Garcia-Casal MN, Osorio C, Landaeta M, Leets I, Matus P, Fazzino F, et al. High prevalence of folic acid and vitamin B12 deficiencies in infants, children, adolescents and pregnant women in Venezuela. Eur J Clin Nutr. 2005;59:1064–70.

Ramirez Velez R, Correa- Bautista JE, Martinez- Torres J, Meneses-Echavez JF, Lobelo F. Vitamin B12 concentration and its Association with Sociodemographic Factors in Colombian Children: Findings from the 2010 National Nutrition Survey. Nutr. 2016;32(2):255-9.

Verma M, Chhatwal J, Kaur G. Prevalence of Anaemia among Urban School Children of Punjab. Indian Pediatr. 1998;35:1181-6.

Ajuria-Morentin I, Mar-Medina C. Determination of Reference Values for Serum Folate and Vitamin B12 Using Three Different Immunoassays: Is it Worth Making an Effort to Produce them in Our Laboratory? Clin Lab. 2014;60:1135-43.

Andrès E, Affenberger S, Zimmer J, Vinzio S, Grosu D, Pistol G, et al. Current Hematological Findings in Cobalamin Deficiency. A study of 201 consecutive patients with documented cobalamin deficiency. Clin Lab Haematol. 2006;28:50-6.

Obeid R, Geisel J, Schorr H, Hu bner U, Herrman W. The Impact of Vegetarianism on SomeHematological parameters. Eur J Haematol. 2002:69:275-9.

Stabler SP, Allen RH, Savage DG, Lindenbaum J. Clinical spectrum and diagnosis of cobalamin deficiency. Blood. 1990;76:871-81.

Stott DJ, Langhorne P, Hendry A, McKay PJ, Holyoake T, Macdonald J, et al. Prevalence and hematopoietic effects of low serum vitamin B12 levels in geriatric patients. Br J Nutr. 1997;78:57-63.

Yüksel S, Uslan, Acartürk G, Çölbay M, Karaman O, Maralcan M, et al. A Retrospective Evaluation of Patients with Vitamin B12 Deficiency. Med J Bak›rköy.2006;2(4):126-9.