Patient Risk Stratification and Demographic Profile based on Serum Vitamin-D Levels: A Cross-Sectional Observational Study

Background: Vitamin D deficiency is now recognized as a pandemic.An estimated 1 billion people worldwide, across all ethnicities and age groups, have a vitamin D deficiency (VDD). This pandemic of hypovitaminosis D can mainly be attributed to lifestyle (for example, reduced outdoor activities) and environmental (for example, air pollution) factors that reduce exposure to sunlight. High prevalence of vitamin D deficiency is a particularly important public health issue because hypovitaminosis D is an independent risk factor for total mortality in the general population.The current study sought to uncover the population-wide true prevalence of Hypovitaminosis D in Bangladesh by harnessing large amount patient data and subsequently analyze the vitamin D levels of the pre-categorized age and gender groups.

Methods: In this cross-sectional observational study, serum samples were collected from 7951 selected cases (including children and adult) who attended both indoor and outdoor department of a Private hospital in Dhaka, Bangladesh. Study period was from July 2017 to June 2018. Levels of 25(OH)D (in ng/ml) was done in every caseusing the chemiluminescent micro-particle immunoassay.

Results: 81.36% (n=6469) of the study population was affected with Hypovitaminosis DOnly a small fraction of study subjects (n=58) representing 0.7% of the total study-population was suffering from vitamin D toxicity. Among the study subjects (n=6469) with Hypovitaminosis D, 56.60% patients (n=4501) were deficient in vitamin D while the rest of the study subjects - 24.70% were insufficient (n=1967). Highest female to male ratio was found for the deficient group (3.52) followed by the insufficient group (2.70) and normative group (2.44). The lowest female to male ratio was identified for toxic group (1.63).Regarding age impact, the predominance of Vitamin D deficiency compared of the study subjects with age from 20 to 60.For males,Vitamin D deficiency fraction is almost uniformly distributed ranging from 39% to 46% across all age group with the exception of the age group ≥80 in which the fraction of the Vitamin D deficient subjects was 25%. In contrast, for females, there was a large variation of in the number of Vitamin D deficient subjects. For instance, the highest fraction of Vitamin D deficient subjects were identified in the age group 10-19 (69%) closely followed by 20-21 (68%) and 30-39 (67%). The later age groups – 40-49, 50-59, 60-69 and 70-79 showed a decreased fraction of Vitamin D deficient subjects – 59%, 53%, 46% and 45% respectively.

Conclusion: As there is continuous increasing number of VDD patients, our findings strengthen the rationale for widespread vitamin D supplementation to prevent premature mortality, emphasize the need for it early in life and mitigate concerns about a possible negative effect at higher levels.

Keywords: Vitamin D deficiency(VDD),Hypovitaminosis D, pandemic.