Vitamin C Deficiency and Oxidant Levels in Children With Transfusion-Dependent β-Thalassemia

OBJECTIVES: To study vitamin C levels in children with transfusion-dependent b-thalassemia and correlate with age, transfusions received and iron overload; and to study the effect of administering vitamin C on its levels and Malondialdehyde (MDA) in deficient patients.

METHODS: This case-control study enrolled 100 children with transfusion-dependent b-thalassemia and 30 healthy controls. MDA levels before and after administration of vitamin C were performed randomly in 36 children with low vitamin C levels.

RESULTS: 81/95 (85.3%) study subjects Vs none in control group, had low plasma vitamin C levels (P<0.001). Vitamin C levels were low in 67.4% of 71 (74.7%) subjects with dietary deficiency, while in none of the 19 (63.3%) children in the control group (P=0.04). Increasing serum ferritin values correlated with vitamin C deficiency (P=0.02). The mean level of MDA reduced (P<0.001) with vitamin C supplementation.

CONCLUSIONS: Low levels of vitamin C are common in children with thalassemia. Dietary counseling along with supplementation with vitamin C, in those with low levels may prevent oxidative stress.