Surrogate Markers of Vitamin D Deficiency Diagnosis

Abstract

The 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 is a need to increase the awareness 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 investigate markers of Vitamin D deficiency applicable in large sectors of society at low cost to diagnose such a widely prevalent condition with reasonable cost benefit ratio. Our study was conducted on 90 healthy adults aged (20-60) ys. Outpatients with minor intercurrent illness, companions of in-patient and healthy hospital workers were volunteers in our study. Samples collected from participants in Cairo (L=30o), during the winter and spring from December to April. All participants were subjected to full medical history taking, General clinical examination and Laboratory investigations including (Hb, S.creatinine, total, ionized Ca, phosphorus, Mg, intact PTH (i- PTH) and 25 hydroxy Vitamin D level). Subjects with chronic systemic diseases were excluded from our study. We classified our volunteers according to Vitamin D status into: Group Ι: Vitamin D deficient group, with Vitamin D level below < 20 ng/ml. Group ΙΙ: Vitamin D insufficient group, with Vitamin D level between 20-29 ng/ml. Group ΙΙΙ: Vitamin D sufficient group, with Vitamin D level 30-100 ng/ml. According to gender into: Group M: males Group F: females According to BMI into: Group N: non obese, with BMI <30 Kg/m 2 Group O: obese, with BMI ≥ 30 Kg/m 2 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 statistically difference between both groups in PTH (p-value < 0.001), but There was no significant statistical difference between both groups in age (p-value> 0.05), HB (p-value > 0.05), Creat (p-value > 0.05), total Ca (p-value > 0.05), ionized Ca (p-value > 0.05), PO4 (p-value > 0.05) Ca-PO4 Product (p-value > 0.05), Mg (p-value > 0.05) and BMI (p-value > 0.05). On comparing Group M (males) with Group F (females) we found that, there was highly significant statistical difference between both groups in HB (p-value < 0.001)and there was significant statistical difference between both groups in Creat (p-value < 0.05), PO4 (p-value < 0.05) Ca-PO4 Product (p-value < 0.05), but there was no significant statistical difference between both groups in age (p-value> 0.05), BMI (p-value> 0.05), total Ca (p-value > 0.05), ionized Ca (p-value > 0.05), Mg (p-value > 0.05), PTH (p-value > 0.05) and Vit.D (p-value > 0.05). On comparing Group N (non obese) with Group O (obese) we found that, there was highly significant statistical difference between both groups in age (p-value < 0.001) and there was significant statistical difference between both groups in total Ca (p-value < 0.05), PO4 (p-value < 0.05) Ca-PO4 Product (p-value < 0.05), but there was no significant statistical difference between both groups in HB (p-value> 0.05), BMI (p-value> 0.05), Creat (p-value > 0.05), ionized Ca (p-value > 0.05), Mg (p-value > 0.05), PTH (p-value > 0.05) or Vit. D (p-value > 0.05).