Determinants of Vitamin D deficiency in asymptomatic healthy young medical students

Abstract

Objective:The study aimed to determine vitamin D status and frequency of its determinants related to diet, clothing, lifestyle and exposure to sunlight among young healthy medical students living in Karachi, Pakistan.Methods:This cross sectional study included responses gathered on questionnaire from medical students of Karachi Medical &Dental College from 4th of August 2017 till 30th April 2018. All the participants were healthy young adult’s year of age who gave written informed consent to participate in the study. Questions regarding demographics, sun exposure, diet, clothing, living patterns and any symptoms like pain or body aches were recorded. Serum 25 (OH) vitamin D3, calcium and phosphorus levels were measured through laboratory examination. For serum 25OHD, the cutoff values ≤ 20ng /ml, ≥ 21-29ng /ml, and ≥ 30ng/ml were defined as deficiency, insufficiency, and sufficiency respectively.Results:Total number of medical students enrolled in the study was 221.Among total participants 191 (86.43%) were females and 30 (13.57%) were males. Mean ± SD age was almost similar (23.00 ± 2.56 vs. 23.03 ± 2.05). Majority of the females 115 (60.2%) had BMI within normal range, and were predominantly single 164 (85.9%). Vitamin D deficiency was found in 197 (89.14%), insufficiency in 16 (7.24%), and only 8 (3.62%) had sufficient levels. Determinant factors reported by deficient group (n=197); fabric color (dark mix) 87.3%, fabric material (synthetic + mix) 48.7%, full length of sleeves by 45.7%, exposure to sun only on hands and face during outdoors was reported by 64.5%, milk up to 250 cc was consumed by 77.2%, one egg per day in diet was taken by 56.9% and intake of cod liver oil was less common in only 27.4%.Conclusion:Deficiency of vitamin D is common among healthy young adults particularly females which emphasize need to add vitamin D supplements in their routine diet.

Serum 25 hydroxyvitamin D levels and affecting factors among preconception fertile women

“…Our findings are also supported by a recent study from Pakistanon vitamin D deficiency in asymptomatic healthy young students. Almost 89 % of participants were vitamin D deficient (25(OH)D < 20 ng/mL) [23]. This is alarming as those women are planning to get pregnant because routine pre-conception check-up projects (Women receive routine pre-pregnancy check-up at 3-6 months before they became pregnant in China) do not include measurement of serum 25(OH)D. Several studies have described an association between insufficiency or deficiency in 25(OH)D levels and adverse pregnancy outcomes including gestational diabetes mellitus, preeclampsia, preterm delivery, recurrent abortion, and intrauterine growth restriction [24][25][26].…”

“…Our findings are also supported by a recent study from Pakistanon vitamin D deficiency in asymptomatic healthy young students. Almost 89 % of participants were vitamin D deficient (25(OH)D < 20 ng/mL) [ 23 ].…”

Correlation of serum levels of Vitamin D3 with serum parathormone in nursing mothers and infants 1-6 months’ age from South Punjab, Pakistan

“…It has been postulated that increasing level of intact parathyroid hormone (iPTH) in response to low VD 3 level is a better biochemical indicator of deficient or insufficient vitamin D levels. Studies from Pakistan have reported VD 3 deficiency in healthy adults 11 , 12 , pregnant women 13 , children 14 , adolescents 15 and have also examined the correlation of VD 3 with PTH levels 16 . But none of the studies from Pakistan have documented the correlation of VD 3 and PTH in dyad of nursing mothers and their infants.…”

Assessment of knowledge, attitudes and practice towards Vitamin D among university students in Pakistan

“…Studies exploring vitamin D deficiency in Pakistan have identified it to be widespread among various segments of the population including asymptomatic adult population, ambulatory patients, mothers and their newborns [16,19,20]. Ninety percent of university students, especially females, aged between 18 and 35 years have been reported as vitamin D deficient [21][22][23].…”