VITAMIN D DEFICIENCY PANDEMIC, A REALITY OR AN OVER DIAGNOSIS? NEED TO RETHINK VITAMIN D DEFICIENCY CUT OFF LEVELS

  • Afshan Bibi Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Naveed Asif Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Zujaja Hina Haroon Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Aamir Ijaz Rehman Medical Institute Peshawar Pakistan
  • Asif Nawaz Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Qurat Ul Ain Atif *Combined Military Hospital Skardu/National University of Medical Sciences (NUMS) Pakistan
Keywords: Cut off levels, iPTH, Secondary hyperparathyroidism, Vitamin D deficiency, 25(OH) D

Abstract

Objective: To determine clinical decision limits (cut off points) for vitamin D deficiency based on secondary hyperparathyroidism.

Study Design: Cross sectional study.

Place and Duration of Study: This study was conducted in the Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (AFIP), from Dec 2016 to May 2017.

Methodology: One hundred and sixteen subjects, aged 18 to 60 years, of either gender, with vitamin D levels less than 50nmol/L, were consecutively included in the study.

Results: Serum 25(OH) D had inverse relation with plasma iPTH level (r=-0.597, p<0.0001). Thirty five percent of the subjects with vitamin D level below 50nmol/L had secondary hyperparathyroidism. However, the frequency of secondary hyperparathyroidism was 52% in subjects with 25 (OH) D level less than 25nmol/L compared with 28% having serum vitamin D levels of 25-40nmol/L. None of the patient with Vitamin D level above 40nmol/L had secondary hyperparathyroidism. Receiver operating characteristic (ROC) curve showed that 25(OH) D level of 25.5nmol/L as an optimal cut off level for vitamin D deficiency based on Secondary Hyperparathyroidism with area under the curve (AUC) was 0.761.

Conclusion: High frequency of secondary hyperparathyroidism in adults with vitamin D levels under 25nmol/L necessitates reconsideration of vitamin D cutoff limit for bone health.

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Published
2020-10-30
How to Cite
Bibi, A., Asif, N., Haroon, Z., Ijaz, A., Nawaz, A., & Atif, Q. U. A. (2020). VITAMIN D DEFICIENCY PANDEMIC, A REALITY OR AN OVER DIAGNOSIS? NEED TO RETHINK VITAMIN D DEFICIENCY CUT OFF LEVELS. Pakistan Armed Forces Medical Journal, 70(5), 1327-31. Retrieved from https://pafmj.org/index.php/PAFMJ/article/view/5558
Section
Original Articles

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