Abstract

Introduction: Vitamin D is a catabolic product of cholesterol metabolism. Conversion of 7-dehydro-cholesterol to active vitamin D is largely dependent upon exposure to Ultraviolet B rays coming from sunlight. The individuals not exposed to adequate sunlight are prone for developing vitamin D deficiency conquest upon inadequate conversion of 7-dehydrocholesterol to provitamin D3 and Active Vitamin D. Vitamin D deficiency is one of the common problems in south East Asian women in child bearing age groups. This is not only detrimental for the women but also may cause intrauterine growth retardation, low birth weight and adverse pregnancy outcome. The common causes of vitamin D deficiency include increasing age, inadequate exposure to sunlight and chronic diseases. In south East Asian countries many females are not adequately exposed to sunlight moreover their nutrition also is deficient in vitamin D. We have conducted this study to know the vitamin D status of females not adequately exposed to sunlight due to reasons like housewives constantly remaining in home, dressing style, young girls using excessive sun screen and those belonging to high socioeconomic status who usually remain in air-conditioned environment mostly restricted to homes, offices or cars.

Aims and Objectives: To determine the frequency of vitamin D deficiency or insufficiency in women residing in twin Cities of Hyderabad and Secunderabad who are not adequately exposed to sunlight.

Materials and Methods: This was a case control study carried out in a tertiary care hospital situated in Hyderabad. 36 Women with no co-morbidities and having history of inadequate exposure to sunlight were enrolled in this study as cases. Control group comprised of women of similar age and physical characteristic who were determined, on the basis of detailed history, to have adequate exposure to sunlight. In both these groups detailed histories was taken with a view to exclude co-morbidities and know the status of sun exposure. Investigations like CBC, Sr Calcium and ALP were done in all the cases. The data was tabulated and analyzed using SPSS 16.0 version software.

Results: The mean weight and BMI were comparable in cases and controls. The mean weight of control group was 59.38 +/- 2.72 kg while in cases group the mean weight was 64.38 +/- 3.52 kg. While mean height in control and cases group was 5.35 +/- 0.047 and 5.178 +/- 0.035 feet respectively. Serum calcium in cases and control groups was 8.869 +/- 0.126 and 8.635 +/- 0.121 while ALP was 98.30 +/- 7.97 and 104.04 +/- 4.770 respectively. Finally 25 (OH) Vit D was found to be 96.27 +/- 8.96 in control group and 73.403 +/- 4.42 in cases group. The findings confirmed the presence of via D insufficiency in cases group i.e. women not exposed adequately to sunlight.

Conclusion: Vitamin D insufficiency and deficiency is a common occurrence in south East Asian women of child bearing age group. This is not only detrimental for women but also may cause an adverse pregnancy outcome. We recommend that all women should adequately be exposed to sunlight and should intentionally expose themselves to sunlight and take food rich in calcium (Fish, egg yolk, non-veg food and milk.). Vitamin D supplementation in appropriate doses should be given to women with vitamin D insufficiency or deficiency.

Keywords: Vitamin D insufficiency, inadequate exposure to sunlight, Vitamin D supplementation.