Medical College, Aga Khan University Hospital, Karachi, Pakistan.
PLoS One. 2012;7(3):e33452. doi: 10.1371/journal.pone.0033452. Epub 2012 Mar 23.
It is well established that low levels of 25(OH) Vitamin D (<30 ng/dL) are a common finding world over, affecting over a billion of the global population. Our primary objective was to determine the prevalence of vitamin D deficiency and insufficiency in the asymptomatic adult population of Karachi, Pakistan and the demographic, nutritional and co-morbidity characteristics associated with serum vitamin D levels.
A cross-sectional population survey was conducted at two spaced out densely populated areas of the city. Serum levels of 25OH vitamin D were measured and GFR as renal function was assessed by using 4 variable MDRD formula.
Our sample of 300 had a median age of 48(interquartile range 38-55) years. The median level of serum vitamin D was 18.8 (IQ range 12.65-24.62) ng/dL. A total of 253 (84.3%) respondents had low levels (<30 ng/dL) of 25OH vitamin D. Serum PTH and vitamin D were negatively correlated (r = -0.176, p = 0.001). The median PTH in the vitamin D sufficiency group was 38.4 (IQ range28.0-48.8)pg/mL compared with 44.4 (IQ range 34.3-56.8) pg/mL in the deficiency group (p = 0.011).The median serum calcium level in the sample was 9.46(IQ range 9.18-9.68) ng/dL. Low serum levels of vitamin D were not associated with hypertension (p = 0.771) or with an elevated spot blood pressure (p = 0.164).In our sample 75(26%) respondents had an eGFR corresponding to stage 2 and stage 3 CKD. There was no significant correlation between levels of vitamin D and eGFR (r = -0.127, p-value = 0.277). Respondents using daily vitamin D supplements had higher 25 OH vitamin D levels (p-value = 0.021).
We observed a high proportion of the asymptomatic adult population having low levels of vitamin D and subclinical deterioration of eGFR. The specific cause(s) for this observed high prevalence of low 25OH vitamin D levels are not clear and need to be investigated further upon.
众所周知,全世界范围内低水平的 25(OH)维生素 D(<30ng/dL)是一种常见现象,影响着全球超过 10 亿人口。我们的主要目标是确定巴基斯坦卡拉奇无症状成年人群中维生素 D 缺乏和不足的流行情况,以及与血清维生素 D 水平相关的人口统计学、营养和合并症特征。
在城市的两个相隔较远的人口密集区进行了一项横断面人群调查。测量了血清 25OH 维生素 D 水平,并使用 4 变量 MDRD 公式评估了肾功能的肾小球滤过率。
我们的 300 名样本的中位年龄为 48(四分位间距 38-55)岁。血清维生素 D 中位数为 18.8(四分位间距 12.65-24.62)ng/dL。共有 253(84.3%)名受访者的血清 25OH 维生素 D 水平较低(<30ng/dL)。血清 PTH 和维生素 D 呈负相关(r=-0.176,p=0.001)。维生素 D 充足组的中位 PTH 为 38.4(四分位间距 28.0-48.8)pg/mL,而缺乏组为 44.4(四分位间距 34.3-56.8)pg/mL(p=0.011)。样本中血清钙的中位数水平为 9.46(四分位间距 9.18-9.68)ng/dL。低水平的维生素 D 与高血压(p=0.771)或单次血压升高(p=0.164)无关。在我们的样本中,75(26%)名受访者的 eGFR 对应于 2 期和 3 期 CKD。维生素 D 水平与 eGFR 之间无显著相关性(r=-0.127,p 值=0.277)。每天服用维生素 D 补充剂的受访者 25OH 维生素 D 水平更高(p 值=0.021)。
我们观察到无症状成年人群中有很大一部分人维生素 D 水平较低,eGFR 出现亚临床恶化。造成这种高比例低 25OH 维生素 D 水平的具体原因尚不清楚,需要进一步调查。