Abstract
Background and objectives: Vitamin D deficiency is now a global concern. Industrialization, urbanization and the decreasing participation in outdoor activities, with consequent sunlight deprivation, are thought to be the key factors in the increasing prevalence of vitamin D deficiency among general population of many countries. It is presumed that healthy, adequately sun-exposed people should maintain adequate vitamin D levels. However, studies within this population are scarce. Hence, this study was conducted to find out the actual vitamin D status in healthy, adequately sun-exposed population living in coastal district of Bangladesh.
 Material and Methods: One hundred and forty healthy fishermen living in costal district of Cox’s Bazar (210 25' North, 910 59' East) of Bangladesh were enrolled in this study. Relevant data and blood samples were collected during August 2018, one of the months with lower zenith angle and higher UV index. Chemiluminescent micro-particle immunoassay (CMIA) was used to measure 25-hydroxy vitamin D3. Other relevant biochemical parameters measured were random blood glucose (RBG), serum creatinine, albumin, calcium, phosphate, alkaline phosphatase and intact parathyroid hormone (iPTH).
 Results: Mean vitamin D level of the study population was 27.04±7.20 ng/ml. Based on the cut off value of Endocrine Society, 70.7% of the study population had low vitamin D levels of which 26 (18.6%) and 73 (52.1%) were in vitamin D deficient (<20ng/ml) and insufficient (20 – 29.99 ng/ml) categories respectively. Vitamin D level was normal in 41 (29.3%) subjects. There was no significant difference in iPTH level between groups with low and normal vitamin D levels (p>.05, 95%CI= -5.68226, 1.21086).
 Conclusion: The unexpectedly high prevalence of vitamin D deficiency in this healthy and adequately sun-exposed population raises the question regarding the validity of the current cutoff value being used to assess the vitamin D status of Bangladeshi population. Future studies should be carried out to determine nation-specific, local cutoff values for vitamin D sufficiency.
 Ibrahim Med. Coll. J. 2019; 13(2): 35-39
Highlights
Human skin using sunlight produces vitamin D3, the cholecalciferol, which is further converted to 25hydroxy vitamin D3 in the liver
There was no significant difference in intact parathyroid hormone (iPTH) level between groups with low and normal vitamin D levels (p>.05, 95%CI= -5.68226, 1.21086)
Significance of sun deprivation and consequent vitamin D deficiency was first recognized in the early 17th century during the industrial revolution and urbanization in Europe
Summary
Human skin using sunlight produces vitamin D3, the cholecalciferol, which is further converted to 25hydroxy vitamin D3 in the liver. Children often prefer to remain indoors rather than going outside and most of the workers work within the building from dawn to dusk This change in life style with less outdoor activity, less sunlight exposure, and less production of ultraviolet-B (UVB)-induced vitamin D in the skin, ended with the pandemic of vitamin D deficiency. Industrialization, urbanization and the decreasing participation in outdoor activities, with consequent sunlight deprivation, are thought to be the key factors in the increasing prevalence of vitamin D deficiency among general population of many countries. It is presumed that healthy, adequately sun-exposed people should maintain adequate vitamin D levels This study was conducted to find out the actual vitamin D status in healthy, adequately sun-exposed population living in coastal district of Bangladesh
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