VITAMIN D DEFICIENCY PANDEMIC, A REALITY OR AN OVER DIAGNOSIS? NEED TO RETHINK VITAMIN D DEFICIENCY CUT OFF LEVELS
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...
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| Autores principales: | , , , , , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Army Medical College Rawalpindi
2020
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/6677203c41a94ae9b5c13261fd7d65f9 |
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| Sumario: | 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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