Abstract
BackgroundIt is well established that low levels of 25(OH) Vitamin D (<30 ng/dL) are a common finding world over, affecting over a billion of the global population. Our primary objective was to determine the prevalence of vitamin D deficiency and insufficiency in the asymptomatic adult population of Karachi, Pakistan and the demographic, nutritional and co-morbidity characteristics associated with serum vitamin D levels.MethodsA cross-sectional population survey was conducted at two spaced out densely populated areas of the city. Serum levels of 25OHVitamin D were measured and GFR as renal function was assessed by using 4 variable MDRD formula.ResultsOur sample of 300 had a median age of 48(interquartile range 38–55) years. The median level of serum vitamin D was 18.8 (IQ range 12.65–24.62) ng/dL. A total of 253 (84.3%) respondents had low levels (<30 ng/dL) of 25OH vitamin D. Serum PTH and vitamin D were negatively correlated (r = −0.176, p = 0.001). The median PTH in the vitamin D sufficiency group was 38.4(IQ range28.0–48.8)pg/mL compared with 44.4(IQ range34.3–56.8) pg/mL in the deficiency group (p = 0.011).The median serum calcium level in the sample was 9.46(IQ range 9.18–9.68) ng/dL. Low serum levels of vitamin D were not associated with hypertension (p = 0.771) or with an elevated spot blood pressure (p = 0.164).In our sample 75(26%) respondents had an eGFR corresponding to stage 2 and stage 3 CKD. There was no significant correlation between levels of vitamin D and eGFR (r = −0.127, p-value = 0.277).Respondents using daily vitamin D supplements had higher 25 OH vitamin D levels (p-value = 0.021).ConclusionWe observed a high proportion of the asymptomatic adult population having low levels of vitamin D and subclinical deterioration of eGFR. The specific cause(s) for this observed high prevalence of low 25OH vitamin D levels are not clear and need to be investigated further upon.
Highlights
Vitamin D is one of the major players involved in calcium homeostasis in the human body
Vitamin D deficiency has been associated with development of osteoporosis due to induction of secondary hyperparathyroidism, which mobilizes calcium out of bones increasing the risk of fall related fractures especially in the elderly [1]
Other decreased bone mineral density vitamin D deficiency can present as rickets and osteomalacia, in the pediatric and adult population respectively[2]
Summary
Vitamin D is one of the major players involved in calcium homeostasis in the human body. It has been shown that sufficient serum levels of vitamin D are needed for bone health and development. Vitamin D deficiency has been associated with development of osteoporosis due to induction of secondary hyperparathyroidism, which mobilizes calcium out of bones increasing the risk of fall related fractures especially in the elderly [1]. Other decreased bone mineral density vitamin D deficiency can present as rickets and osteomalacia, in the pediatric and adult population respectively[2]. It has been associated with myopathy and may hold key while addressing to unexplained aches and pains presentations in the outpatient setting [3]. Our primary objective was to determine the prevalence of vitamin D deficiency and insufficiency in the asymptomatic adult population of Karachi, Pakistan and the demographic, nutritional and co-morbidity characteristics associated with serum vitamin D levels
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