Comparative study of bone mineral density, calcium, and vitamin D status in the Gujarati and white populations of Leicester

Abstract

Objectives: To evaluate differences in bone mineral density (BMD), calcium, and vitamin D status between the Gujarati (South Asian) and white populations resident in Leicester and to determine whether this was linked to lifestyle factors. Design: An observational cross sectional study of randomly selected Gujarati and white volunteers aged from 20-40 years. Setting: City of Leicester. Participants: Subjects were randomly selected by age (20-40 years) and ethnicity. A total of 262 individuals volunteered to participate, of which 201 (51 white females, 71 Gujarati females, 37 white males, 42 Gujarati males) were eligible for the study. Main outcome measures: Results of questionnaire, BMD at the hip and lumbar spine, and measurement of serum calcium, albumin, alkaline phosphatase, and 25-hydroxyvitamin D.Results: Male and female white subjects were significantly taller and heavier than their Gujarati counterparts. There was a statistically significant difference in BMD both at the spine (p<0.001) and hip (p<0.001) between the white and Gujarati females with the Gujaratis having a lower BMD. There was a trend for Gujarati males to have a lower BMD at the hip and spine than their white counterparts but these figures did not reach statistical significance. The intensity of cigarette smoking and the amount of alcohol consumption were both higher in the white male and female subjects. Sunlight exposure (>4 hours per day) was significantly higher in white subjects compared with Gujaratis. There were no significant differences in the mean level of serum calcium or alkaline phosphatase between the Gujaratis and whites. A significantly higher proportion (p<0.001) of the Gujarati men and women had a vitamin D level that was not measurable (that is, below the lower limit of the laboratory range of normal). Of those who had a measurable level (that is, in the normal range) mean levels of vitamin D were lower (p<0.05) in the Gujarati men and women. Conclusion: The present study is the first of its kind to note a low BMD in Gujarati subjects of South Asian origin compared with their white counterparts, living in Leicester. This study also confirms the presence of low serum vitamin D levels in Gujaratis. There is a need for more research in South Asians with regard to the collection of normal BMD values. This could provide a more meaningful reference range for identifying South Asians at risk of osteoporotic fractures and may have public health implications of relevance to this ethnic group.

Bone health in healthy Indian population aged 50 years and above

“…Strong positive correlation of BMI with BMD at all sites and negative correlation with PTH, ALP, and phosphates seen in the present study was also observed by several other workers [6,7,39]. There was no significant correlation observed between serum 25(OH)D and BMD at different sites which is in concordance with our earlier studies [8-11, 13, 32].…”

Can vitamin D replacement reduce insulin resistance in South Asians with vitamin D deficiency?

“…However, overall the recent results suggests that there is a still high burden of relatively low vitamin D levels in the South Asian general population and is similar to other reports (Ford et al, 2006;Hamson et al, 2003;Hull et al, 2010).…”

“…Migrant South Asians living in the UK have among the highest rates of VDD (Ford et al, 2006;Hamson et al, 2003;Hull et al, 2010). Pilot data South Asians also have a high prevalence of T2DM and it is plausible that this relates directly to sub-optimal Vitamin D status (Boucher et al, 2006).…”

Prevalence and predictors of vitamin D deficiency in five immigrant groups living in Oslo, Norway: the Oslo Immigrant Health Study

“…Only 10% of the women and 8% of the men with Pakistani background had s-25(OH)D of 50 nmol/l or more, compared to 86% of men and women with Norwegian background. A high prevalence of vitamin D deficiency among immigrants has also been reported in other Northern European countries, such as Denmark (Glerup et al, 2000;Pedersen et al, 2003) and the UK (Shaw & Pal, 2002;Hamson et al, 2003). However, the evidence is limited and the preponderance of studies are not populationbased but conducted in clinical settings.…”