Vitamin D deficiency: a concern in premenopausal Bangladeshi women of two socio-economic groups in rural and urban region

Abstract

Objective: The study was designed to evaluate the vitamin D status in women of different physiological status of two socioeconomic groups in Bangladesh. Design: A cross-sectional study, using serum 25-hydroxyvitamin D (25-OHD), calcium, phosphorus and alkaline phosphatase activity. Setting: Two regions of Bangladesh. The Dhaka city area and west region of Nandail (Betagair Union), Mymensingh. Subjects: Representative subjects of two groups (low socio-economic group ¼ group L, n ¼ 99; and high socio-economic group ¼ group H, n ¼ 90) of Bangladeshi women aged 16 -40 y. About 87% of the subjects were housewives and the rest, 13%, were distributed among other different professions. Each group comprised of three sub-groups (non-pregnant nonlactating ¼ 1, pregnant ¼ 2, and lactating ¼ 3). Results: The influence of socio-economic status and physiological status on serum 25-OHD concentration (P ¼ 0.038, P ¼ 0.015, respectively), serum calcium concentration (P < 0.001, P < 0.001, respectively) and alkaline phosphatase activity (P < 0.001, P < 0.001, respectively) were observed. The distribution of serum 25-OHD concentration in both groups was shifted overall toward the lower limit of the normal range. Seventeen percent of women in group L and 12% of women in group H had serum 25-OHD concentration < 25 nmol=l. Hypovitaminosis D (serum 25-OHD concentration 37.5 nmol=l) was observed in 50% of subjects in group L and 38% of subjects in group H, respectively. The prevalence of hypovitaminosis was higher in lactating subjects of the groups L and H (63 and 46%, respectively) than in the other sub-groups in the same group. Conclusions: The results of the study suggested that women in Bangladesh were at risk of hypovitaminosis D and lactation was an additional risk factor in low income groups. The situation may increase the risk of bone loss.

Dietary calcium intake in premenopausal Bangladeshi women: do socio-economic or physiological factors play a role?

“…However, the low intake of calcium in the study subjects could increase the risk of osteoporosis (Peacock, 1998) because low calcium intake coupled with long periods of elevated calcium requirement may adversely affect bone mineral mass. In addition, a high prevalence of hypovitaminosis D was shown in these subjects of two groups in our earlier study (Islam et al, 2002). The available evidence suggests that insufficiency of both calcium and vitamin D throughout life could increase the fracture burden due to osteoporosis many-fold.…”

“…This study is a part of study focused on nutritional status in Bangladeshi women (Islam et al, 2001;2002).The purpose of the present study was to estimate the habitual dietary calcium intake and to study the sources of calcium in the diets of these two groups.…”

Cardiovascular Disease in Bangladesh: A Review

“…114 High prevalence of suboptimal serum 25(OH)D level (<25 nmol/l) was described in lactating women of low socioeconomic status and those wearing Shari, a traditional ladies wear. 115 In another survey of women aged 18-60 years, serum 25(OH)D levels were <40 nmol/ l in 78% of 36 university students and 83% of 30 veiled women. 116 Further research is needed to evaluate the association, if any, between vitamin D deficiency and CAD in Bangladesh.…”

Global vitamin D status and determinants of hypovitaminosis D

“…In Bangladesh (24°N), hypovitaminosis D is common in women regardless of age, lifestyle, and clothing [33]. Prevalence of hypovitaminosis defined as 25(OH)D levels below 37.5 nmol/L was 38% in Bangladeshi women from high-income group and increased slightly to 50% in women from low income groups [34]. In Sri Lanka (7°N), mean 25(OH)D among healthy females was 35.3 nmol/L, and 40.5% of them had 25(OH)D values below 25 nmol/L [35].…”