Assessment of Vitamin D Levels and Bone-Related Biochemical Markers in Healthy Adults in Pakistan: Influence of Socio-Demographic and Environmental Factors: Vitamin D Levels and Bone-Related Biochemical Markers in Healthy Adults

Fawad Hussain; Saima Tabassum; Sobia Parveen; Tehmeena Munawar; . Anam; Asma Ali

doi:10.54393/pjhs.v6i3.2425

Authors

Fawad Hussain Department of Medicine, Niazi Medical and Dental College, Sargodha, Pakistan
Saima Tabassum Department of Physiology, Niazi Medical and Dental College, Sargodha, Pakistan
Sobia Parveen Department of Biochemistry, Rai Medical College, Sargodha, Pakistan
Tehmeena Munawar Department of Culture and Health Sciences, International Institute of Technology, Gujranwala, Pakistan
. Anam Department of Physiology, Niazi Medical and Dental College, Sargodha, Pakistan
Asma Ali Department of Physiology, Niazi Medical and Dental College, Sargodha, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i3.2425

Keywords:

Pregnancy, Vitamin D, Parathyroid Hormone, Albumin

Abstract

Vitamin D is an essential nutrient that plays a crucial role in bone health, calcium homeostasis, and immune function. Objectives: To assess the levels of vitamin D by age, gender, sunlight exposure, education level, calcium levels, parathyroid hormone (PTH) levels, and albumin levels. Methods: The cross-sectional study was carried out at the Department of Community Medicine, Niazi Medical and Dental College, Sargodha. This study was carried out over half a year from January 2024 to June of the same year. A total number of responders was n=246. Socio-demographic data were collected on the responder's age, gender, number of family members, occupation, education levels, and house type using a structured questionnaire. Blood samples were collected to assess serum vit D levels, and other biochemical indicators used were albumin, calcium phosphate, and parathyroid hormone (PTH). Results: Vitamin D deficiency was prevalent, especially in female, older individuals, and those with low sun exposure. Male had higher levels (16.5 ng/mL) than female (14.2 ng/mL). Deficient individuals (<12 ng/mL) showed lower calcium and higher PTH levels, indicating secondary hyperparathyroidism. Only 14.6% were sufficient (>20 ng/mL). Vitamin D levels were significantly associated with age, gender, sun exposure, education, calcium, and PTH (p<0.05). Conclusions: It was concluded that there was a significant correlation between vitamin D deficiency with age, gender, sun exposure, education level, calcium, PTH, and albumin levels.

References

Żebrowska A, Sadowska-Krępa E, Stanula A, Waśkiewicz Z, Łakomy O, Bezuglov E et al. The Effect of Vitamin D Supplementation On Serum Total 25 (OH) Levels and Biochemical Markers of Skeletal Muscles in Runners. Journal of the International Society of Sports Nutrition. 2020 Apr; 17(1): 18. doi: 10.1186/s12970-020-00347-8. DOI: https://doi.org/10.1186/s12970-020-00347-8

Szulc P, Bauer DC, Eastell R. Biochemical Markers of Bone Turnover in Osteoporosis. In Marcus and Feldman's Osteoporosis. 2021 Jan: 1545-1588. doi: 10.1016/B978-0-12-813073-5.00065-4. DOI: https://doi.org/10.1016/B978-0-12-813073-5.00065-4

Sureshkumar A and Nagappan KV. A Comprehensive Review On the Biomarkers of Bone Remodeling in Vitamin D Deficiency. Indonesian Journal of Pharmacy. 2021: 280-90. doi: 10.22146/ijp.1792. DOI: https://doi.org/10.22146/ijp.1792

Makris K, Bhattoa HP, Cavalier E, Phinney K, Sempos CT, Ulmer CZ et al. Recommendations on the Measurement and the Clinical Use of Vitamin D Metabolites and Vitamin D Binding Protein–A Position Paper from the IFCC Committee On Bone Metabolism. Clinica Chimica Acta. 2021 Jun; 517: 171-97. doi: 10.1016/j.cca.2021.03.002. DOI: https://doi.org/10.1016/j.cca.2021.03.002

Brzeziański M, Migdalska-Sęk M, Stuss M, Jastrzębski Z, Radzimiński Ł, Brzeziańska-Lasota E et al. Effect of Physical Training on Parathyroid Hormone and Bone Turnover Marker Profile in Relation to Vitamin D Supplementation In Soccer Players. Biology of Sport. 2022 Oct; 39(4): 921-32. doi: 10.5114/biolsport.2022.109956. DOI: https://doi.org/10.5114/biolsport.2022.109956

Yarparvar A, Elmadfa I, Djazayery A, Abdollahi Z, Salehi F. The Association of Vitamin D Status with Lipid Profile and Inflammation Biomarkers in Healthy Adolescents. Nutrients. 2020 Feb; 12(2): 590. doi: 10.3390/nu12020590. DOI: https://doi.org/10.3390/nu12020590

Alonso N, Zelzer S, Eibinger G, Herrmann M. Vitamin D Metabolites: Analytical Challenges and Clinical Relevance. Calcified Tissue International. 2023 Feb; 112(2): 158-77. doi: 10.1007/s00223-022-00961-5. DOI: https://doi.org/10.1007/s00223-022-00961-5

Bikle DD. Vitamin D: Newer Concepts of Its Metabolism and Function at the Basic and Clinical Level. Journal of the Endocrine Society. 2020 Feb; 4(2): bvz038. doi: 10.1210/jendso/bvz038. DOI: https://doi.org/10.1210/jendso/bvz038

Bocheva G, Slominski RM, Slominski AT. The Impact of Vitamin D On Skin Aging. International Journal of Molecular Sciences. 2021 Aug; 22(16): 9097. doi: 10.3390/ijms22169097. DOI: https://doi.org/10.3390/ijms22169097

Giustina A, Bouillon R, Dawson-Hughes B, Ebeling PR, Lazaretti-Castro M, Lips P et al. Vitamin D in the Older Population: A Consensus Statement. Endocrine. 2023 Jan; 79(1): 31-44. doi: 10.1007/s12020-022-03208-3. DOI: https://doi.org/10.1007/s12020-022-03208-3

Wierzbicka A and Oczkowicz M. Sex Differences in Vitamin D Metabolism, Serum Levels and Action. British Journal of Nutrition. 2022 Dec; 128(11): 2115-30. doi: 10.1017/S0007114522000149. DOI: https://doi.org/10.1017/S0007114522000149

Cashman KD. Vitamin D Deficiency: Defining, Prevalence, Causes, and Strategies of Addressing. Calcified Tissue International. 2020 Jan; 106(1): 14-29. doi: 10.1007/s00223-019-00559-4. DOI: https://doi.org/10.1007/s00223-019-00559-4

Książek A, Mędraś M, Zagrodna A, Słowińska-Lisowska M, Lwow F. Correlative Studies On Vitamin D and Total, Free Bioavailable Testosterone Levels in Young, Healthy Men. Scientific Reports. 2021 Oct; 11(1): 20198. doi: 10.1038/s41598-021-99571-8. DOI: https://doi.org/10.1038/s41598-021-99571-8

Rejnmark L and Ejlsmark-Svensson H. Effects of PTH and PTH Hypersecretion On Bone: A Clinical Perspective. Current Osteoporosis Reports. 2020 Jun; 18: 103-14. doi: 10.1007/s11914-020-00574-7. DOI: https://doi.org/10.1007/s11914-020-00574-7

Liu Q, Wang Y, Chen Z, Guo X, Lv Y. Age-and Sex-Specific Reference Intervals for Blood Urea Nitrogen in Chinese General Population. Scientific Reports. 2021 May; 11(1): 10058. doi: 10.1038/s41598-021-89565-x. DOI: https://doi.org/10.1038/s41598-021-89565-x

Koek WN, Campos-Obando N, van der Eerden BC, De Rijke YB, Ikram MA, Uitterlinden AG et al. Age-Dependent Sex Differences in Calcium and Phosphate Homeostasis. Endocrine Connections. 2021 Mar; 10(3): 273-82. doi: 10.1530/EC-20-0509. DOI: https://doi.org/10.1530/EC-20-0509

Bikle DD. The Free Hormone Hypothesis: When, Why, and How to Measure the Free Hormone Levels to Assess Vitamin D, Thyroid, Sex Hormone, and Cortisol Status. Journal of Bone and Mineral Research Plus. 2021 Jan; 5(1): e10418. doi: 10.1002/jbm4.10418. DOI: https://doi.org/10.1002/jbm4.10418

Altasan A. Ethnic, Body Composition and Dietary Factors as Determinants of Vitamin D Status. Drexel University. 2021.

Simpson CA, Zhang JH, Vanderschueren D, Fu L, Pennestri TC, Bouillon R et al. Relationship of Total and Free 25-Hydroxyvitamin D to Biomarkers and Metabolic Indices in Healthy Children. The Journal of Clinical Endocrinology and Metabolism. 2020 Apr; 105(4): e1631-40. doi: 10.1210/clinem/dgz230. DOI: https://doi.org/10.1210/clinem/dgz230

Ding F, Nie X, Li X, He Y, Li G. Data Mining: Biological and Temporal Factors Associated with Blood Parathyroid Hormone, Vitamin D, and Calcium Concentrations in the Southwestern Chinese Population. Clinical Biochemistry. 2021 Apr; 90: 50-7. doi: 10.1016/j.clinbiochem.2021.01.014. DOI: https://doi.org/10.1016/j.clinbiochem.2021.01.014

Liu N, Sun J, Wang X, Zhang T, Zhao M, Li H. Low Vitamin D Status Is Associated with Coronavirus Disease 2019 Outcomes: A Systematic Review and Meta-Analysis. International Journal of Infectious Diseases. 2021 Mar; 104: 58-64. doi: 10.1016/j.ijid.2020.12.077. DOI: https://doi.org/10.1016/j.ijid.2020.12.077

Al-Daghri NM, Yakout S, Aljohani N, Al-Saleh Y, Al-Attas OS, Reginster JY et al. Vitamin D Status and Its Correlation with Parathyroid Hormone Level Among Population in Riyadh, Saudi Arabia. Journal of King Saud University-Science. 2020 Apr; 32(3): 2016-9. doi: 10.1016/j.jksus.2020.02.002. DOI: https://doi.org/10.1016/j.jksus.2020.02.002