Nutritionnal status and the levels of folate and vitamin B12 in patients with Thalassemia intermedia at Siriraj Hospital

Abstract

This study aimed to evaluate the nutritional status, the levels of folate in serum and RBC, serum vitamin B12, and the relations between nutritional parameters, hematological parameters, and the levels of folate and vitamin B12 in patients with thalassemia intermedia at Pediatric Hematology Clinic, Siriraj Hospital. Thirty subjects (12 males and 18 females) aged between 5 - 15 years participated in the study. Nutritional status assessed by subjective global assessment showed that all subjects had normal nutritional status. However, when the nutritional status was evaluated by the percentages of weight for age, weight for height, height for age, triceps skinfold thickness, and mid arm circumference, the prevalence of malnutrition in these subjects were 63.3%, 50.0%, 36.7%, 60.0% and 70.0% respectively. According to the percentiles of body mass index for age, 50% of the subjects were underweight. The patients had average total energy intake (1,469.9 ± 61.6 Kcal per day) lower than the dietary reference intake. Serum total protein and albumin levels were in the normal range. The mean levels of serum and RBC folate in these patients were 37.9 ± 2.7 and 297.6 ± 23.6 ng/ml respectively. The mean level of serum vitamin B12 was 679.7 ± 29.8 pg/ml. This study found that several nutritional parameters were correlated with each other. It was found that hemoglobin was positively correlated with MAMC (R = 0.376, p = 0.040) and AMA (R = 0.366, p = 0.047). In addition, serum levels of folate and vitamin B12 were negatively correlated with some anthropometric parameters. However, there was no correlation between serum and RBC folate, serum vitamin B12 and hematological parameters. This study demonstrated that patients with thalassemia intermedia had malnutrition which needs to be evaluated nutritional status by combination methods. Therefore, the nutritional counseling is necessary to improve nutritional status, growth development as normal children, quality of life and effectiveness of treatment.