Endocrine Abstracts

Background: UK South Asians (SA) are at risk of vitamin D deficiency (VDD, defined as 25-OH vitamin D <25 nmol/l) and insufficiency (VDI, 25-OH vitamin D 25–49 nmol/l), which increases the risk of metabolic bone disease. As VDD and VDI are often asymptomatic, many individuals will be unaware of this metabolic abnormality. As there is little information on how to detect VDD/VDI in the community, we wished to investigate if they were identified more effectively using either a population or targeted method.

Methods: The VITALITY study is a randomised controlled trial of vitamin D replacement in VDD SA; the screening phase involved detecting VDD. Individuals who had not taken vitamin D and/or calcium therapies for at least two months presented to screening sessions consisting of a 25-OH vitamin D measurement, through self-referring after seeing local advertisements in magazines, internet health websites or at promoting events (population method). Secondly, primary care computer databases were searched based on criteria that increase the chances of finding VDD including BMI, waist circumstance or prediabetes (targeted method).

Results: From December 2012 to October 2013, 63 individuals were screened with a mean age of 48.5 years. The mean 25-OH vitamin D level was 32.9 nmol/l (S.D. 20.7) and 23 (36.5%) people were VDD with a further 27 (42.9%) with VDI. Only 13 (20.6%) individuals had a 25-OH vitamin D ≥50 nmol/l. Comparing targeted and population methods (n=21 and 42 respectively), there were no significant differences for mean 25-OH vitamin D levels (31.9 nmol/l (22.0) vs 34.4 nmol/l (20.8), P=0.68). 33.3% of people in the targeted group had VDD compared to 38.9% in the population group, P=0.55; for VDD and VDI combined these numbers were 80.9 and 76.2%, respectively, P=0.53.

Conclusion: VDD and VDI are common in SA, which is probably why the targeted method did not detect more cases than the population method.