Vitamin D deficiency tied to increased pain-related hospitalizations in children with SCD

Low vitamin D levels were associated with an increased incidence of pain events leading to hospital admission among children with sickle cell disease (SCD), according to a study presented at ASH 2021.

“Individuals with SCD are at high risk for vitamin D deficiency due to dark skin colour, limited physical activity, poor nutrition, and renal dysfunction,” said lead author Dr Latika Puri from Loma Linda Children’s Hospital in Loma Linda, California, US. “[Previous] small retrospective studies [have shown] that vitamin D deficiency in SCD is also associated with increased frequency of acute pain events and higher opioid use.”

Using data from the Sickle Cell Clinical Research and Intervention Program (SCCRIP) database, the researchers conducted a retrospective longitudinal study involving 799 patients with SCD (mean age 8.7 years, 50.19 percent male) who had a mean baseline vitamin D level of 19 ng/dL. Of these, 527 patients had a low vitamin D level of ≤20 ng/dL (deficient group) and 272 patients had a normal vitamin D level of >20 ng/dL (nondeficient group). Pediatric Quality of Life Inventory™ Sickle Cell Disease Module (PedsQL™ SCD) was used to assess pain and hurt and pain impact scores between the vitamin D deficient and nondeficient groups. [ASH 2021, abstract 3089]

Within 2 years of the first vitamin D measurement, the number of pain-related hospitalizations was significantly higher in patients with vitamin D deficiency than those with normal vitamin D levels (mean 0.81 vs 0.66; p=0.0034).

Patients with vitamin D deficiency also demonstrated significantly lower pain and hurt score (mean 74.57 vs 83.5; p<0.001) and pain impact score (mean 66.7 vs 75.5; p<0.001), in which higher scores indicate a better health-related quality of life, compared with patients with normal vitamin D levels.

“[Overall,] results indicated that low vitamin D levels predicted higher frequency of painful events leading to a hospital visit and were [also] associated with higher prevalence of self-reported pain and pain interference,” concluded Puri.

“Therefore, further studies evaluating the mechanisms by which vitamin D influences sickle cell pain and larger controlled trials to help evaluate the therapeutic efficacy of vitamin D [supplementation] for sickle cell pain are warranted,” Puri noted.