Vitamin D Deficiency in ambulatory patients.
OBJECTIVE
To determine the frequency of subclinical vitamin D deficiency in an ambulatory care setting.


METHODS
This was an observational study which measured 25 vitamin D levels in medical clinic patients. Patients with chronic renal failure, known osteomalacia and rickets were excluded. A total of 119 patients were evaluated. They were divided in three diagnostic categories based on their serum 25 vitamin D levels. Those with levels below 8 ng/ml were categorized to have severe deficiency, levels between 8 - 20 ng/ml as moderate deficiency and levels of 21-35 mg/ml as mild deficiency.


RESULTS
Of 119 patients, 92% had vitamin D deficiency. Their mean age was 44.3 +/- 18.3 years, with female to male ratio of 5:1. Sixty two percent (62%) had severe, 24% moderate and 8% had mild deficiency. Nearly half of all these patients (including those with severe deficiency) were asymptomatic. Whereas a low serum calcium, elevated phosphate and elevated alkaline phosphatase were reflective of severe deficiency. It was only an elevated iPTH that correlated with mild to moderate deficiency.


CONCLUSIONS
Subclinical vitamin D deficiency is extensive in the adult ambulatory care patients. Serum calcium, phosphate and alkaline phosphatase are poor markers of moderate to mild deficiency. A serum 25 vitamin D level and an iPTH are better biofunctional markers of this deficiency.
Department of Medicine, Aga Khan University Hospital, Karachi.
Lubna M
LM
Zuberi
Aysha
A
Habib
Naeemul
N
Haque
Abdul
A
Jabbar
D000328:Adult; D000553:Ambulatory Care; D015415:Biomarkers; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D009752:Nutritional Status; D010154:Pakistan / Q000453:epidemiology; D010865:Pilot Projects; D015995:Prevalence; D012307:Risk Factors; D014808:Vitamin D Deficiency / Q000175:diagnosis / Q000453:epidemiology*
D015415:Biomarkers