ABSTRACT
Background: Vitamin D a fat soluble unique micronutrient. Deficiency of vitamin D is widely prevalent in Indian Subcontinent despite wide exposure to sunlight round the year. Vitamin D is considered to be most under evaluated and under treated micronutrient round the world. Elderly persons are more prone to develop Vitamin D deficiency because of risk factors. Methods: This study was done to study the prevalence of vitamin D deficiency in healthy adults for southern Rajasthan and its correlation with gender, dietary habits and habitat (urban or rural residence).We evaluated apparently healthy adults of age more than 50 years presenting to hospital for routine evaluation or as accompanying person with patient between January to July 2015.The serum -25 OH CHOLECALCIFEROL (D2+D3) levels were estimated in all the subjects by COBAS e411 (Hitachi, Roche). Results: The study (Males 121, Females 83), aged 50 – 82 years shows normal level (20-32 nag/ml) in only 26% (53), while 74% (151) had <20ng/ml. Women were more deficient (64%) than males (36%); vegetarians more [93% (140)] than non-vegetarians [7% (11)]; urban more 90% (51/56) than rural 69% (100/148). All those who received supplementation improved clinically and bio chemically. Conclusions: Despite abundant sunshine Vitamin D deficiency prevalence is very high among females, vegetarians and urban subjects, for which presumably conventional female over clothing, strict vegetarianism and urban crowdedness are responsible. Supplementation normalizes Vitamin D deficiency. Therefore, proper food fortification in healthy looking and diseased elderly persons is advised.
ABSTRACT
15-year-old adolescent girl presented with weight gain, irregular menstrual cycle, skin lesions suggestive of acanthosis nigricans and hirsutism. On evaluation, she was found to have elevated testosterone levels with normal FSH, LH and fasting blood sugar, decreased glucose insulin index suggestive of Insulin resistance. In view of above features, diagnosis of hyperandrogenism-insulin resistance-acanthosis nigricans syndrome (HAIR-AN syndrome) was made. This syndrome is considered as a sub-type of polycystic ovary syndrome (PCOS). HAIR-AN syndrome has varied presentation and is usually seen by primary care physician, gynaecologist or dermatologist. Life style modification with weight reduction and drugs such as metformin helps in alleviating the symptoms. With limited resources in our country, diagnosis is frequently delayed leading to systemic complications. Early diagnosis and appropriate treatment would help in preventing complications of obesity, insulin resistance leading to coronary artery disease, Type 2 diabetes mellitus, hyperlipidemia. Depression and suicidal behavior may be associated with it and should be aggressively addressed in young adults suffering from HAIR-AN syndrome.