Prevalence of Vitamin D Deficiency in a Population of Indian Women- A Call for Universal Supplementation?

Abstract

BACKGROUND With improvement in serum vitamin D testing, there emerged an understanding that Vitamin D Deficiency (VDD) exists in sunny regions of the world where it was once thought to be a rare occurrence. In addition, new understanding on the deleterious effects of VDD on health has also grown over the last several years to include not only skeletal disorders, but cardiovascular disease, diabetes, cancer, infectious and autoimmune diseases. The aim of the study was to examine the prevalence of Vitamin D Deficiency (VDD) among pregnant and non-pregnant women at a Multispecialty Hospital in Bengaluru, India. MATERIALS AND METHODS This is a retrospective chart review study. Charts belonging to all women who presented to Divakars Speciality Hospital from October 1, 2015, to November 1, 2016, were selected for initial review. Charts for all non-pregnant women who presented for a routine annual checkup and pregnant women in their 12th week of pregnancy were reviewed. All charts selected included serum 25 (OH) D levels that were obtained as part of routine care services. Charts of 213 pregnant women and 370 nonpregnant were reviewed. Serum 25 (OH) D levels for each patient were collected and entered into a Microsoft® Excel spreadsheet for analysis by physician researchers along with information regarding patient's age, employment status and education level. Serum 25 (OH) D level of 20.0 to <30.0 ng/mL was classified as vitamin D insufficiency and levels <20 ng/mL were classified as being vitamin D deficient. Data were compiled as percentages and means across population characteristics. Pearson's correlations were calculated to assess the correlation between 25 (OH) D levels and population parameters. A P value of <0.05 was considered statistically significant. RESULTS The mean age of the pregnant women and non-pregnant women was 29 and 43, respectively. Mean serum vitamin D level of pregnant women and non-pregnant women was 15.1 and 19.4, respectively. Ninety seven percent of pregnant women and 86% of non-pregnant women were vitamin deficient or insufficient. Vitamin D levels were not correlated to income or education in either pregnant women or non-pregnant women. Vitamin D levels were not correlated to age in pregnant women, but a correlation was found in non-pregnant women (r=0.223747; P=0.000014). CONCLUSION This study joins a significant number of previous studies in providing evidence of widespread VDD in south Asian populations. It underscores the need for vitamin D supplementation and fortification guidelines in India, especially considering the deleterious health effects of VDD.

Pooled estimate of vitamin D deficiency among pregnant women in India: a systematic review and meta-analysis

“…Among Asian countries, in India, the prevalence of vitamin D deficiency among healthy pregnant women is reportedly high [ 4 , 7 ]. Individual studies report 93% prevalence in Delhi, 97% in Bangalore, Karnataka, and 94% in Mumbai, Maharashtra [ 6 , 8 , 9 ]. High prevalence has been reported among women in reproductive age group both in rural and urban areas, as well as across economic classes [ 4 ].…”