Start Submission Become a Reviewer

Reading: Vitamin D deficiency, associated factors & possible adverse outcomes in a tertiary care inst...

Download

A- A+
Alt. Display

Original Papers

Vitamin D deficiency, associated factors & possible adverse outcomes in a tertiary care institute in Sri Lanka

Authors:

I. Ranathunga ,

National Hospital of Sri Lanka, LK
X close

J. P. Naveenkumar,

National Hospital of Sri Lanka, LK
X close

M. Sumanatilleke,

National Hospital of Sri Lanka, LK
X close

N. P. Somasundaram

National Hospital of Sri Lanka, LK
X close

Abstract

Background & objective: Around 50 % of the population is affected with vitamin D insufficiency worldwide. Vitamin D has multiple actions in the body and out of that calcium homeostasis is one of its many roles. It is also needed for bone growth and bone remodeling by osteoblasts and osteoclasts. Furthermore, recent research has demonstrated that vitamin D has impact on several biologic processes with several clinical implications including obesity, diabetes mellitus, and metabolic syndrome, cancer, cardiovascular disease and immune function. Studies on factors associated with vitamin D deficiency and its complications in local setting are lacking. We studied the vitamin D status, associated factors and outcome of patients attending the NHSL.

 

Methods: A descriptive cross sectional study was conducted from March/ 2019 to March/ 2020 at the Endocrinology Unit of the National Hospital of Sri Lanka. Consecutive sampling was done recruiting all patients who have had vitamin D assessment as part of the routine medical care. Interviewer administered questionnaire was used collect data. Vitamin D sufficiency, insufficiency and deficiency was defined on levels of > 50ng/ ml, 20-50ng/ ml, <20ng/ ml respectively. Categorical and numerical variables were analyzed using Chi-square and independent sample t-tests respectively.

 

Results: 153 subjects who meets the inclusion and exclusion criteria were recruited in to the study over a period of one year. Out of the study population, majority were females (85.6%). The population mean age was 52.1 (SD ± 14.38) years and ranged from 18-89 years. The mean weight was 59.4 (SD± 15.70) kg and BMI was 31.3 (SD± 7.54) kg/m-2 Out of the whole population 58.8% had vitamin D deficiency while 31.4 % suffered from vitamin D insufficiency. Only 9.8% the values within the normal range. The mean vitamin D status of the population is 20.9 ng/ml. Out of the possible factors causing a lower vitamin D level being included in the Muslim ethnicity, lack of education, lower income, lack of milk in the diet, the more time spent watching television, and use of clothes covering more than 90% a body surface area and having a darker skin had lower vitamin D level when compared to the other categories. The more falls (3-4 falls during the last year), the presence of cardiovascular disease, recent upper respiratory infection, chronic pain, chronic fatigue syndrome, hypertension, depression and periodontal disease had a tendency towards to association with low /insufficient vitamin D level though the value is not statistically significant. Multiple Linear Regression Analysis was carried out to determine the predictors of vitamin D status. Out of the possible factors skin colour had a significant association with vitamin D insufficiency and deficiency (F=4.355, p<0.05). Other factors such as ethnicity, education level, employment status, monthly income, marital status, no of family members, no of dependents, food preference, frequency of fish/meat intake out of non-vegetarians, frequency of milk intake, screen time per day, outdoor hours per day, sunscreen use and use of clothes which cover >90% body service area (BSA) did not exhibit a significant association the vitamin D status of the population.

 

Conclusions: Majority of the patients who has undergone vitamin D level assessment in the study setting had Vitamin D levels in the deficient or insufficient range. Being included in the Muslim ethnicity, lack of education, lower income, lack of milk in the diet, the more time spent watching television, and use of clothes covering more than 90% a BSA and having a darker skin is likely to predispose lower vitamin D status. Vitamin D insufficiency and deficiency is possibly associated with more falls, the presence of cardiovascular disease, recent upper respiratory infection, chronic pain, chronic fatigue syndrome, hypertension, depression and periodontal disease cardiovascular disease, recent upper respiratory tract infection, chronic pain and chronic fatigue syndrome. Further large-scale studies to recognize potential causes and outcomes are needed in the future.

How to Cite: Ranathunga, I., Naveenkumar, J.P., Sumanatilleke, M. and Somasundaram, N.P., 2022. Vitamin D deficiency, associated factors & possible adverse outcomes in a tertiary care institute in Sri Lanka. Sri Lanka Journal of Diabetes Endocrinology and Metabolism, 13(2), pp.5–19. DOI: http://doi.org/10.4038/sjdem.v13i2.7480
0
Views
0
Downloads
Published on 08 Dec 2022.
Peer Reviewed

Downloads

  • PDF (EN)

    comments powered by Disqus