Sufficiency of Vitamin D Among Egyptian Men Living in Cairo

Abstract

SUMMARY T he vitamin D deficiency pandemic increases the entire world’s population risk of the most serious chronic illnesses including deadly cancers, type 2 diabetes, heart disease, stroke, autoimmune diseases, asthma and infectious diseases. Thus there needs to be increased awareness on the part of the medical community and public about the insidious consequences of vitamin D deficiency. Although vitamin D deficiency is prevalent, measurement of serum 25 (OH) D levels is expensive, so vitamin D testing is limited to those at risk for severe deficiency and universal screening is not supported. The aim of this study is to evaluation of the magnitude of Vitamin D deficiency / sufficiency in a sample of healthy Egyptian men between 25-60 years old. Healthy Egyptian males aged (25 - 59) years, coming to the hospital for pre-employment checkup were invited to volunteer for our study of vitamin D sufficiency screening. The purpose of the study was explained and a written consent was obtained. Exclusion criteria: Subjects with chronic systemic diseases like: chronic liver diseases, chronic kidney diseases, diabetes mellitus, congestive heart failure, chronic obstructive pulmonary diseases, endocrinological diseases & neurological disease, also subjects on vitamin D and calcium supplements were excluded from the study The latest Endocrine society clinical practice guidelines were used the classify the study according to vitamin D status into: (Holick et al., 2011). Our results revealed the following: On comparing Group Ι (vitamin D deficient group) with Group ΙΙ (vitamin D insufficient group), we found that, there was highly significant difference between both groups in PTH (p < 0.001) and age (p < 0.001), but There was no significant difference between both groups in, total Ca (p > 0.05), PO4 (p-value > 0.05), and BMI (p-value > 0.05) On correlating different parameters with vitamin D we found that, there was highly significant negative correlation between Vitamin D and PTH (r=-0.2) (p <0.0001), but a non significant correlation found between vitamin D and other parameters. ROC curve done to assess the predictive accuracy of PTH, total calcium, phosphorous as markers for vitamin D status, results show that PTH with cut off value ≥ 43.6 pg/ml has sensitivity 98.8% and specificity 100 % with predictive accuracy 98.8 %. By conducting multiple stepwise regression analysis PTH, Ca and BMI were predictors for Vitamin D among the study variables.

CONCLUSION & RECOMMENDATION Conclusion:  Our results show a high prevalence of vitamin D deficiency among healthy Egyptian men living in Cairo. Recommendation:  Vitamin D deficiency is so widespread that a combination of food fortification for the total population and individual screening for people in groups at risk for this important deficiency is needed.  Awareness by the general public, healthcare providers and health insurance systems of the importance of vitamin D adequacy and sun exposure could have a dramatic impact on the health and welfare of all children and adults.