Garg Shobhit, Dasgupta Aparajita, Paul Bobby, Maharana Swanya P
Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India.
Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India.
Indian J Endocrinol Metab. 2019 Sep-Oct;23(5):552-556. doi: 10.4103/ijem.IJEM_539_19.
Vitamin D Deficiency/Insufficiency (VDD/VDI) is now recognized as a pandemic. Vitamin D is a versatile yet crucial factor which is vital for many metabolic functions in our body. Till now there is no screening tool for VDD/VDI. The aim of this study is to develop and validate a screening tool Vitamin D Insufficiency Risk Score (VDIRS).
This study was a rural community based cross-sectional study. It was done during May 2016 to April 2017 among 197 adults residing in rural West Bengal. After a thorough literature review and discussion with the field experts, four characteristics (BMI, Physical activity, Daily Sun exposure, Diet) were considered for VDIRS. Data was collected after taking informed consent. After interviewing every individual was examined for height, weight and blood was collected for vitamin 25-(OH) D. Weights were given to VDIRS characteristic according to Adjusted Odds' Ratio. Receiver Operating Characteristics (ROC) curves were utilized to validate and find out optimum cut off for VDIRS using Youden's index for VDD/VDI with the use of R software.
Only 133 (67.5%) had Vitamin D insufficiency. On ROC curves for VDIRS for VDI and VDD, AUC was 0.83 and 0.77 which signifies VDIRS as a good screening and predictive tool. A score of VDIRS ≥14 had sensitivity of 78.2% and specificity of 75.0% for VDI.
Use of the VDIRS can make mass screening for undiagnosed VDI/VDD in India more cost effective. Researchers strongly believe and perceive a necessity of such validated score in the present scenario.
维生素D缺乏/不足(VDD/VDI)目前被认为是一种流行病。维生素D是一种多功能但至关重要的因素,对我们身体的许多代谢功能至关重要。到目前为止,还没有针对VDD/VDI的筛查工具。本研究的目的是开发并验证一种筛查工具——维生素D不足风险评分(VDIRS)。
本研究是一项基于农村社区的横断面研究。于2016年5月至2017年4月在西孟加拉邦农村的197名成年人中进行。在对文献进行全面综述并与领域专家讨论后,考虑了VDIRS的四个特征(体重指数、身体活动、每日日照时间、饮食)。在获得知情同意后收集数据。在对每个人进行访谈后,测量其身高、体重,并采集血液检测维生素25 -(OH)D。根据调整后的优势比为VDIRS特征赋予权重。利用受试者工作特征(ROC)曲线,使用R软件,通过约登指数对VDD/VDI验证并找出VDIRS的最佳截断值。
只有133人(67.5%)存在维生素D不足。在VDI和VDD的VDIRS的ROC曲线上,曲线下面积(AUC)分别为0.83和0.77,这表明VDIRS是一种良好的筛查和预测工具。VDIRS≥14分时,对VDI的敏感性为78.2%,特异性为75.0%。
使用VDIRS可以使印度对未诊断的VDI/VDD进行大规模筛查更具成本效益。研究人员坚信并认为在当前情况下有必要有这样经过验证的评分。