Society for Endocrinology BES 2009
Harrogate, UK
16 March 2009 - 19 March 2009
Society for Endocrinology
British Endocrine Societies
The utility of routine biochemistry in detecting vitamin D deficiency in South Asians with and without type 2 diabetes
1University of Birmingham, Birmingham, UK; 2Birmingham Heartlands Hospital, Birmingham, UK.
Background: Vitamin-D deficiency and type 2 diabetes (T2D) are common in South Asians (SA). The diagnosis of a vitamin-D deficiency in the setting of a chronic disease depends on a high index of suspicion and adequate investigation. This involves bone profile, occasionally in conjunction with serum 25-hydroxyvitamin-D. The ability of routine investigations to identify vitamin-D deficient patients have not been widely studied.
Aims: To assess the ability of routine biochemistry to detect vitamin-D deficiency.
Methods: A cross-sectional study. One seventy patients with and 40 without T2D were randomly selected. All participants were SA, >40 years old, had normal creatinine and none were taking any calcium or vitamin-D supplements. Data collected: demographics, PTH, calcium, phosphate, alkaline phosphatise (ALP), urea&creatinine, and serum 25-hydroxycholecalciferol-D. Vitamin-D deficiency was defined by serum 25-hydroxycholecalciferol levels <12.5 nmol/l.
Results: Twenty seven (14%) patients in the entire cohort were vitamin D deficient. Only 6 (22%) of the vitamin-D deficient patients had abnormal bone profiles. 5 (18.5%) had a low phosphate, 2 (7.4%) a high ALP and none a low calcium. 1 (3.7%) patient had more than one abnormality. However, these patients did have significantly lower Vitamin D levels (10 vs 30 nmol/l; P=0.002) and an abnormal bone profile may therefore be a marker of more severe disease. The remaining 21 (78%) would have been missed by routine biochemistry alone. PTH was elevated in only 63% of vitamin-D deficient patients and is therefore inadequate as a screening tool.
Conclusion: Vitamin-D deficiency is common in UK SA with and without T2D. The majority of vitamin-D deficient patients had a normal bone profile and more than a third had normal PTH. Routine bone profiles and PTH levels are insensitive and should not be used for screening. However, they may provide value in assessing disease severity.
Endocrine Abstracts (2009) 19 P27