Relationship between serum 25-hydroxyvitamin D and red blood
cell indices in German adolescents
Received: 30 November 2017 /Revised: 9 January 2018 /Accepted: 10 January 2018 / Published online: 31 January 2018
Springer-Verlag GmbH Germany, part of Springer Nature 2018
Since the impact of vitamin D on red blood cell formation has not been well studied, we aimed at assessing the putative link
between serum 25-hydroxyvitamin D (25[OH]D) concentrations and hematological markers of erythropoiesis in a large cohort of
German adolescents aged 11 to 17 years. In total, 5066 participants from the population-based, nationally representative KiGGS
study (Kinder- und Jugendgesundheitssurvey, German Health Interview and Examination Survey for Children and Adolescents)
were grouped into either tertiles or clinically accepted cutoff levels for serum 25(OH)D. Results demonstrated significant and
inverse correlations between 25(OH)D levels and several hematological parameters including hemoglobin concentration (r = −
0.04, p = 0.003), mean corpuscular hemoglobin (r = − 0.11, p < 0.001), red blood cell count (r = − 0.04, p = 0.002), and soluble
transferrin receptor (r = − 0.1, p < 0.001), whereas, in contrast, serum 25(OH)D was positively correlated to the mean corpuscular
volume of erythrocytes (r =0.08,p < 0.001). Multinomial regression models adjusted for clinically relevant confounders con-
firmed statistically significant differences between the two strata of 25(OH)D groups with respect to red blood cell markers
(hemoglobin concentration, red blood cell count, mean corpuscular volume, and corpuscular hemoglobin, as well as iron and
soluble transferrin receptor).
Conclusions: The link between serum 25(OH)D and several important hematological parameters may point to an inhibitory
role of vitamin D in the regulation of erythropoiesis in adolescents.
What is Known:
• The physiological effects of vitamin D on calcium homeostasis and bone metabolism have been established.
• However, much less is known about the impact of circulating vitamin D on erythropoiesis.
What is New:
• Data from the KiGGS study in German adolescents demonstrated significant associations between serum vitamin D concentrations and red blood cell
• Further studies should be conducted to decipher the underlying mechanisms of vitamin D on erythropoiesis.
Keywords Vitamin D
Red blood cells
In contrast to the well-documented role of vitamin D in calci-
um metabolism resulting in enhanced intestinal calcium trans-
port and bone mineral mobilization, very little is known about
the effects of this prototypical seco-steroid hormone in the
regulation of tissue differentiation and apoptosis [6, 10].
Aside from maintaining calcium and phosphate homeostasis,
25-hydroxyvitamin D (25[OH]D) or its hormonally active
metabolite 1,25-dihydroxycholecalciferol (1,25-
Communicated by Mario Bianchetti
* Thomas Meyer
Department of Psychosomatic Medicine and Psychotherapy, German
Centre for Cardiovascular Research, University of Göttingen,
Waldweg 33, 37073 Göttingen, Germany
Department of Child and Adolescent Psychiatry and Psychotherapy,
University Medical Center, Göttingen, Germany
European Journal of Pediatrics (2018) 177:583–591