Inadequate vitamin D level: association with low energy fractures of distal radius in young patients and its predictors in Karachi, Pakistan

ABSTRACT

Background:The objective of the study was to determine association of inadequacy of vitamin D level with low energy fractures of distal radius and its predictors in young patients in Karachi Pakistan. Methods:Cross-sectional study was conducted on 220 young patients, visited hospital with low energy fracture of distal radius.A questionnaire was designed and filled after taking consent includes details regarding age, gender, occupation, area of skin and sun exposure duration, dietary habits, type of clothing and residence used. Serum Vitamin D3 levels were determined and compared with serum calcium levels, serum phosphorus and alkaline phosphatase levels.Results:Among 220 patients ranging from 12-45 years, mean 28±23.33SD. Female were 172(78.18%). Mostly have history of fall 127(57.72%)and RTA 63(28.63). Sun exposure duration in majority of participant was 1-2 hour/day 132(60%). Variable coloured clothes used by majority participant 135(61.36%) and variable fabric 102(46.36%). 202(91.8%) patients had deficiency of vitamin D and correlated with duration of sunlight exposure significantly, also with exposure of large skin area, dietary consumption of vitamin D rich food and worn variable clothing colours. Serum phosphorus level and serum alkaline phosphatase level were negatively correlated with vitamin D significantly whereas positively correlated with serum calcium.Conclusions:Prevalence of vitamin D deficiency is very high in low energy fracture of distal radius in young populationand sun exposure duration found to be most common predictor of inadequate D levels. A national food fortification program and campaign of public awareness to increase sunlight exposure and increase intake of vitamin D rich food are urgently needed.