Background
Methods
Subject selection
Screening
Serum 25(OHD assay
Serum calcium and alkaline phosphatase
Genotyping
Sample size and statistical analysis
Results
Participants enrolment
Demographic characteristics
Characteristics | N (%) | |
---|---|---|
Age | 15–30 years | 134 (62 %) |
31–45 Years | 81 (38 %) | |
Mean age, years (S.D) | 28.36 (7.24) | |
Range, years | 15–45 | |
Settings | University students | 92 (43 %) |
Employed | 56 (26 %) | |
Religious settings | 67 (31 %) | |
Month of recruitment | January-March | 104 (48 %) |
April - July | 111 (52 %) | |
Marital Status | Single | 84 (39 %) |
Married | 131 (61 %) | |
Province/place of origin | Punjabi | 150 (70 %) |
NWFPa | 32 (15 %) | |
Gilgit Baltistan | 33 (15 %) | |
Education | Illiterate | 27 (13 %) |
5–10 years of education | 91 (42 %) | |
11–16 years of education | 97 (45 %) | |
Incomeb | Lower Income | 77 (36 %) |
Intermediate income | 87 (40 %) | |
Higher income | 51 (24 %) | |
Body mass index | BM1 < 25 kg/m2 | 126 (59 %) |
BMI ≥ 25 kg/m2 | 89 (41 %) | |
Preferred food itemc | Homemade food | 108 (50 %) |
Junk food | 107 (50 %) | |
Milk Intake | Yes | 92 (43 %) |
No | 123 (57 %) | |
Sun exposure time/day | ≤30 min | 116 (54 %) |
>30 min | 99 (46 %) | |
Body area exposed | Veil | 114 (47 %) |
No veil | 101 (53 %) | |
Taking Multivitamin | Yes | 78 (36 %) |
No | 137 (64 %) | |
25-hydroxyvitamin D level (nmol/l) | Mean (S.D) | 40.43 (34.45) |
<25 nmol/l | 92 (43 %) | |
25–49.9 nmol/l | 64 (30 %) | |
50–74.9 nmol/l | 37 (17 %) | |
≥75 nmol/ | 22 (10 %) |
Social determinants of vitamin D status
Determinants | 25(OH) D < 50 nmol/l | Univariate analysis | Multivariate analysis | |||
---|---|---|---|---|---|---|
Odds ratio (95 % CI) | p-value | dAdjusted odds ratio (95 % CI) | p-value | |||
Age | 15–30 years | 90/134 (67 %) | Ref | - | Ref | - |
31–45 years | 66/81 (81 %) | 2.15 (1.10–4.18) | 0.02 | 1.63 (0.74–3.58) | 0.22 | |
Settings | University students | 60/92 (65 %) | 1.7 (0.83–3.44) | 0.14 | ||
Religious institutes | 45/56 (80 %) | 0.78 (0.32–1.92) | 0.60 | |||
Employed | 51/67 (76 %) | Ref | - | |||
Month of recruitment | January-Marcha | 85/104 (81 %) | 2.51 (1.34–4.73) | 0.004 | 2.38 (1.20–4.70) | 0.01 |
April-Julyb | 71/111 (64 %) | Ref | - | Ref | - | |
Marital status | Single | 53/84 (63 %) | Ref | - | Ref | - |
Married | 103/131 (78 %) | 2.15 (1.17–3.95) | 0.01 | 1.49 (0.72–3.09) | 0.27 | |
Education | Illiterate | 24/27 (89 %) | 4.12 (1.15–14.71) | 0.03 | 4.0 (1.03–15.52) | 0.04 |
5–10 years | 68/91 (75 %) | 2.70 (0.74–9.8) | 0.13 | 2.71 (0.68–10.72) | 0.15 | |
11–16 years | 64/97 (66 %) | Ref | - | Ref | - | |
Income | Lower income | 54/77 (70 %) | 1.02 (0.47–2.21) | 0.95 | ||
Intermediate income | 66/87 (76 %) | 0.70 (0.35–1.66) | 0.56 | |||
Higher income | 36/51 (70 %) | Ref | - | |||
Preferred food item | Homemade food | 84/108 (78 %) | Ref | - | Ref | - |
Junk food | 72/107 (67 %) | 1.70 (0.92–13.12) | 0.08 | 1.31 (0.67–2.57) | 0.42 | |
Body exposure | Full body covered/veil | 70/114 (61 %) | 1.60 (0.93–2.75) | 0.31 | ||
Some parts exposed | 86/101 (85 %) | Ref | - | |||
Sun exposure time/day | ≤30 min | 89/116 (77 %) | 2.09 (1.14–43.85) | 0.01 | 2.13 (1.08–4.19) | 0.02 |
>30 min | 67/99 (68 %) | Ref | - | Ref | ||
Milk intake | Yes | 61/92 (66 %) | Ref | - | Ref | - |
No | 95/123 (77 %) | 1.72 (0.94–3.15) | 0.07 | 1.46 (0.74–2.88) | 0.26 | |
Province/place of origin | Punjabi | 109/150 (73 %) | Ref | - | ||
Othersc | 47/65 (72 %) | 1.01 (0.53–1.95) | 0.95 | |||
BMI | <25 kg/m2 | 87/126 (69 %) | Ref | - | ||
≥25 kg/m2 | 69/89 (77 %) | 1.54 (0.82–2.8) | 0.17 | |||
Use of a multivitamin supplement | Yes | 32/78 (41 %) | Ref | - | Ref | - |
No | 124/137 (90 %) | 2.56 (1.38–4.74) | 0.002 | 2.61 (1.32–5.16) | 0.005 |
SNP | Genotype | Serum 25(OH) D <50 nmol/L N (%) | aOR (95 % CI) | P value |
---|---|---|---|---|
VDR, rs731236a | AA | 53/65 (81 %) | Ref | - |
AG/GG | 72/94 (77 %) | 1.57 (0.65–3.78) | 0.31 | |
VDR, rs1544410b | CC | 36/45 (80 %) | Ref | - |
CT/TT | 92/118 (80 %) | 1.72 (0.65–4.54) | 0.26 | |
VDR, rs2228570c | GG | 85/107 (79 %) | Ref | - |
GA/AA | 43/57 (75 %) | 2.07 (0.84–5.09) | 0.11 | |
CYP2R1, rs10500804d | GG | 33/44 (75 %) | Ref | - |
GT/ TT | 90/115 (78 %) | 0.76 (0.30–1.93) | 0.57 | |
CYP2R1, rs2060793e | GG | 60/81 (74 %) | Ref | - |
GA /AA | 66/79 (83 %) | 0.57 (0.21–1.23) | 0.13 | |
Cyp2R1, rs10766197f | AA | 28/38 (74 %) | Ref | - |
AG/ GG | 98/124 (79 %) | 0.83 (0.32–2.15) | 0.70 | |
DBP, rs7041g | AA | 29/36 (80 %) | Ref | - |
AC/CC | 96/124 (77 %) | 1.16 (0.41–3.24) | 0.77 | |
DBP, rs4588h | GG | 63/76 (83 %) | Ref | - |
GT /TT | 65/88 (74 %) | 2.21 (0.89–5.00) | 0.09 |
Genetic determinants of vitamin D status
Determinants of bone pain/ body ache
Determinants | Presence of Bone Pain/ Body ache (N = 111) | Univariate analyses | Multivariate analyses | |||
---|---|---|---|---|---|---|
Odds ratio (95 % CI) | p-value | aAdjusted odds ratio (95 % CI) | p-value | |||
Age | 15–30 years | 61/134 (45 %) | Ref | - | Ref | - |
31–45 years | 50/81 (65 %) | 1.93 (1.10–3.47) | 0.02 | 0.76 (0.37–1.55) | 0.46 | |
Settings | University students | 42/92 (455 %) | 0.71 (0.36–1.32) | 0.23 | ||
Religious institutes | 32/56 (57 %) | 1.11 (0.53–2.21) | 0.83 | |||
Employed | 37/67 (55 %) | Ref | - | |||
Marital status | Single | 21/84 (25 %) | Ref | - | Ref | - |
Married | 90/131 (70 %) | 6.58 (3.55–12.20) | <0.001 | 7.11 (3.44–16.70) | <0.001 | |
Education | Illiterate | 17/27 (66 %) | 1.24 (0.29–0.93) | 0.03 | 0.57 (0.20–1.56) | 0.27 |
5–10 years | 38/91 (44 %) | 0.52 (0.26–1.96) | 0.62 | 1.58 (0.56–4.48) | 0.38 | |
11–16 years | 56/97 (57 %) | Ref | - | Ref | - | |
Socioeconomic status | Lower class | 38/77 (48 %) | 0.86 (0.42–1.75) | 0.70 | ||
Middle class | 46/87 (55 %) | 1.01 (0.50–2.01) | 1.0 | |||
Upper class | 27/51 (55 %) | Ref | - | |||
Preferred food item | Homemade food | 63/108 (61 %) | Ref | Ref | ||
Junk food | 48/107 (44 %) | 1.72 (1.0–2.95) | 0.05 | 0.62 (0.33–1.18) | 0.15 | |
Milk intake | Yes | 48/92 (53 %) | Ref | |||
No | 63/123 (52 %) | 1.03 (0.60–1.70) | 0.90 | |||
BMI | <25 kg/m2 | 62/126 (49 %) | Ref | |||
≥25 kg/m2 | 49/89 (57 %) | 1.35 (0.80–2.20) | 0.40 | |||
Multivitamin use | Yes | 39/78 (50 %) | Ref | |||
No | 72/137 (54 %) | 1.10 (0.63–2.02) | 0.70 | |||
Serum 25(OH)D concentration | <50 nmol/l | 95/156 (60 %) | 4.18 (2.16–8.08) | 0.001 | 4.43 (2.07–9.49) | <0.001 |
≥50 nmol/l | 16/59 (27 %) | Ref | Ref |
Sensitivity and specificity of hypocalcaemia and raised serum alkaline phosphatase in identifying vitamin D deficiency
Serum Calcium | 25(OH)D <50 nmol/L | 25(OH)D ≥50 nmol/L | Sensitivity | Specificity |
---|---|---|---|---|
≤9.5 mg/dl | 121 | 43 | 77.56 % | 27.12 % |
>9.5 mg/dl | 35 | 16 |
Serum alkaline phosphatase | 25(OH)D <50 nmol/L | 25(OH)D ≥50 nmol/L | Sensitivity | Specificity |
---|---|---|---|---|
<280 IU/L | 62 | 11 | 60.25 % | 18.64 % |
≥280 IU/L | 94 | 48 |