RESUMO
BACKGROUND AND OBJECTIVE: Recent studies have shown that vitamin D plays an important role in many disease processes. However, data is lacking which correlates the common symptoms attributed with vitamin D levels. This study was undertaken to find the correlation of symptoms and Vitamin D levels among ethnic Saudi Arabian population. METHODS: A structured questionnaire was made and translated in the Arabic language, which included, age, weight and height, ethnicity and marital status. Patients who were visiting orthopaedic clinics for the first time were included after a detailed history, which ruled out any associated metabolic conditions. Patient's biometric data and the answering of the questionnaire were conducted by one of the senior members of the research group. The symptoms which were included in the questionnaire were fatigue, muscle cramps, joint and back pain, blood sugar levels, recurrent infections, hair loss, mood swings, weight gain, irritable bowel, fractures and history of malignancy. All the scores were graded between 1 and 9 (mildest 1 and severe 9) and only for fracture and malignancy it was yes/no answer. A score of ≤4 was accepted as no impact of the vitamin D levels on symptoms and answer of ≥5 was accepted as impact on the symptoms. Residents whose mother tongue was Arabic conducted all interviews. Blood was collected for 25 OHD levels, calcium and parathyroid hormone levels. Deficiency of vitamin D was defined as ≤20 ng/ml, insufficiency 21-29 ng/ml and normal level ≥30 ng/ml. The data was entered in the data base and analyzed using SPSS Inc Version 20. RESULTS: Two hundred one patients completed the questionnaire but for final analysis the data of 187 was available for analysis as in 14 patients some of the data was missing. All were females and the average age was 55.9 ± 12.4 years, weight 78.9 ± 14.2 kg and height was 1.56 ± 7.01 m. The mean calcium level was 9.12 ± 0.33 mg/dl and, parathyroid hormone was 8.1 ± 6.06 pc/ml. The average 25 hydroxy vitamin D3 (25OHD) level was 21.8 ± 10.22 ng/ml. Forty-four (23.5%) of women had a normal vitamin D level, 51 (27.27%) had insufficiency and 92 (49.19%) had deficiency. Patients who complained of muscle cramps had 25OHD level of 18.86 ± 8.73 compared to patients who had no complains of cramps, 23.45 ± 9.2 ng/ml (p < 0.001) and symptom severity score (SSC) p value of p < 0.000. The results were similar for fatigue, Back pain, hair loss, mood swings and weight gain of P < 0.04, p < 0.07, p < 0.05, <0.03 and p < 0.09 for vitamin D levels and p < 0.001 for SSS. Forty-eight (25.6%) had a previous fracture in their history. CONCLUSIONS: This study shows that many symptoms, which have been attributed to low vitamin D levels, are not true. Muscle Cramps, fatigue, mood swings, hair loss, back pain and weight gains appears to be more common in patients with low 25OHD levels.
Assuntos
Deficiência de Vitamina D/fisiopatologia , Vitamina D/sangue , Adulto , Idoso , Alopecia/sangue , Alopecia/etiologia , Artralgia/sangue , Artralgia/etiologia , Glicemia/metabolismo , Fadiga/sangue , Fadiga/etiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Cãibra Muscular/sangue , Cãibra Muscular/etiologia , Arábia Saudita/epidemiologia , Inquéritos e Questionários , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/epidemiologia , Aumento de PesoRESUMO
BACKGROUND AND OBJECTIVE: The objective of this systematic review was to determine from published data the prevalence of Vitamin D deficiency in the Saudi population. METHODS: An extensive and meticulous search was conducted for studies published in MEDLINE, EMBASE the Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (2008-2015), and the Science Citation Index published data from the Annals of Saudi Medicine and Saudi Medical Journal with the key words: Vitamin D deficiency, insufficiency, and Saudi Arabians. The inclusion criterion was studies published during 2008 to 2015, and studies involving healthy individuals between the age of 18 and 80 years. Binary random- effect model was used to estimate pooled Vitamin D deficiency. Prevalence rates along with overall estimate were presented by forest plot. Heterogeneity test was used to assess the significance of heterogeneity among studies. RESULTS: The authors identified 26 potentially relevant articles, 16 of which met the inclusion criteria. A total of 20,787 patients were analyzed. Sixty-two percent (12,959) were females, and the rest were males. The overall Vitamin D deficiency was 63.5% (95% CI: 53.3, 73.7). CONCLUSIONS: The currently available literature on the Saudi Arabian population suggests that the Vitamin D deficiency is around 60% and not 100% as indicated in some studies. The relatively small number of studies on the population and the different modes of diagnostic methodology used make the issue of correct figures of Vitamin D deficiency contentious.