Vitamin D deficiency and low bone status in adult female garment factory workers in Bangladesh

Abstract

The manufacture of garments is the main industry in Bangladesh and employs 1·6 million female workers. Due to the indoor lifestyle and low dietary intake of calcium, we hypothesised that they are at risk of low vitamin D and bone mineral status. Two hundred female garment workers (aged 18-36 years) were randomly selected. Serum 25-hydroxyvitamin D (S-25OHD), serum intact parathyroid hormone (S-iPTH), serum calcium (S-Ca), serum phosphate (S-P) concentration and serum alkaline phosphatase activity (S-ALP) were measured from fasting samples. Bone indexes of hip and spine were measured by dual-energy X-ray absorptiometry. The mean S-25OHD (36·7 nmol/l) was low compared to that recommended for vitamin D sufficiency. About 16 % of the subjects were found to be vitamin D-deficient (S-25OHD , 25 nmol/l). We observed a high prevalence (88·5 %) of vitamin D insufficiency (S-25OHD , 50 nmol/l) as well as a significant inverse relationship between S-25OHD and S-iPTH (r 20·25, P# 0·001). A decrease in S-25OHD (,38 nmol/l) and an increase in S-iPTH (. 21 ng/l) was associated with progressive reduction in bone mineral density at the femoral neck and lumbar spine. According to the WHO criteria, the mean T-score of the femoral neck and lumbar spine of the subjects were within osteopenic range. We observed that subjects with a bone mineral density T-score , 22·5 had a trend of lower values of BMI, waist -hip circumference, mid-upper-arm circumference, S-25OHD and higher S-iPTH and S-ALP. The high prevalence of hypovitaminosis D and low bone mineral density among these subjects are indicative of higher risk for osteomalacia or osteoporosis and fracture. Osteoporosis is a disease in which the density of bone is decreased with a consequent increase in bone fragility and susceptibility to fracture risk. Women are four times more likely than men to develop this disease. Osteoporosis has profound implications for an individual and for the economics of society. Although the exact mechanisms that lead to osteoporosis are not fully understood, two major determinants are known: peak bone mass during childhood and adolescence, and the rate of bone loss during ageing (1)

Low serum vitamin D among community-dwelling healthy women in Sri Lanka

“…In North India, 91% of healthy school girls [7] and 84% of pregnant women [8] were found to have hypovitaminosis D with the cut-off value for serum 25(OH)D level below 50 nmol/L. Similar data have been reported from Pakistan [9] and Bangladesh [10]. Vitamin D status of the population in South-East Asian countries has received relatively less attention.…”

“…Despite the abundant sunlight, previous studies have reported a high prevalence of vitamin D deficiency in South Asian countries [10,[18][19][20]. In fact, a comparison of the present findings on serum vitamin D data with other studies may not be entirely appropriate as the studies have been conducted in different seasons, with different study subjects and using different assays.…”

Peranan Ultraviolet B Sinar Matahari terhadap Status Vitamin D dan Tekanan Darah pada Wanita Usia Subur

“…Rata-rata kadar serum 25(OH)D wanita berusia di atas 40 tahun di perkotaan sedikit lebih rendah dibanding hasil penelitian ini, yaitu 12,76 ng/dL. Islam et al, 16 menyebutkan bahwa wanita yang bekerja 14 _ 16 jam setiap hari di perusahaan garmen mempunyai serum 25 (OH)D rendah yaitu 14,68 ng/mL.…”

Health issues affecting female internal migrant workers: A systematic review

“…Health and social issues of internal migrant workers have been highlighted from different parts of the world including China, Bangladesh, Nepal, Thailand, Cambodia, and Mexico (14)(15)(16)(17)(18)(19)(20)(21). High prevalence of nutritional deficiencies such as anaemia, and Vitamin A and D deficiencies were found among female garment factory workers in Dhaka, Bangladesh (14,15).…”