• Jawed Altaf Baig
  • Shehnaz A Sheikh
  • Ibnat Islam
  • Mukesh Kumar


Background: Vitamin D helps in maintaining bone and muscle health. Vitamin D deficiency is a global problem, with the prevalence of deficiency being widespread in Pakistan. The present study was planned to associate serum vitamin D, Parathyroid Hormone (PTH), calcium and phosphate concentrations with dietary habits of individuals living in urban/rural areas of Sindh, Pakistan. Methods: This was a cross-sectional study at two locations, urban (Karachi) and rural (Haji Goth of Shadadpur city). The study period was May–October 2012 on 176 healthy subjects, aged 20–80 years. Venous blood was collected for analysis of vitamin D, PTH, calcium and phosphorus. Statistical analysis was done using SPSS-18. Statistical differences between variables were determined by student’s t-test and p<0.05 was considered significant. Results: The 176 subjects were divided into non-vegetarians (93, 52.84%) and vegetarians (83, 47.16%) with each group subdivided into urban and rural. The BMI of non-vegetarians vs vegetarians was high (p<0.001). Vitamin D in non-vegetarians vs vegetarians was low (p<0.001). The vegetarians of urban compared to rural had low vitamin D (p<0.05). The PTH of non-vegetarians vs vegetarians was significantly high (p<0.001). Serum calcium was significantly low (p<0.05) in urban and rural subjects on either diet. Conclusion: Non-vegetarians had severe vitamin D deficiency, while vegetarians had vitamin D insufficiency irrespective of belonging to urban or rural area.Keywords: Vitamin D, deficiency, insufficiency, non-vegetarians, vegetarians


Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers and cardiovascular disease. Am J Clin Nutr 2004;80(6 Suppl):1678S–88S.

Holick MF. Vitamin D: A millennium perspective. J cell Biochem 2003;88:296–307.

Voet D, Voet JG. Biomolecules, mechanism of enzyme action, and metabolism. Biochemistry Volume 1 (2004) 3rd ed. New York; John Wiley & Sons: p. 663–4.

Holick MF. Resurrection of vitamin D deficiency and rickets. J Clin Invest 2006;116:2062–72.

Emilion E, Emelion R. Estimation of the 25 (OH) vitamin D thresholds below which secondary hyperparathyroidism may occur among African migrant women in Paris. Int J vitamin Nutr Res 2011;81(4):218–24.

Holick MF. Vitamin D deficiency. N Eng J Med 2007;357:266–81.

Bischoff-Ferrari HA, Dietrich T, Orav EJ, Hu FB, Zhang Y, Karlson EW. et al. Higher 25-OH vitamin concentratrions are associated with better lower extremity function in both active and inactive persons aged ≥60 y. Am J Clin Nutr 2004;80:752–8.

Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decrease bio-availability of vitamin D in obesity. Am J Clin Nutr 2000;72:690–3.

Elina Hypponen. Obesity leads to vitamin D deficiency. Obesity-leads-to-vitamin D deficiency-Hyponen. [accessed on 8-9-2013]

Silva H, Massoud A, Ashraf A, Peyvand A Bijan I. Prevalence of vitamin D deficiency among adult population of Isfahan City, Iran. J Health Popul Nutr 2011;29(2):149–55.

Zuberi LM, Habib A, Haque N, Jabbar A. Vitamin D deficiency in ambulatory patients. J Pak Med Assoc 2008;58(9):482–4.

National Nutrition Survey 2011 http:/ of/inClick. asp x? fileticket=seqAUZ5Dw%3D&tabid=117&mid=752 [accessed on 9-9-2013]

Matsuoka LY, Ide L, Wortsman J, MacLaughlin JA, Holick MF. Sunscreens suppress cutaneous vitamin D3 synthesis. J Clin Endocrnol Metab 1987;64:1165–8.

Sheikh SA, Baig JA, Iqbal T, Kazmi T, Baig M, Hussain SS. Prevalence of microalbuminuria with relation to glycemic control in Type-2 diabetic patients in Karachi. J Ayub Med Coll Abbottabad 2009;21(3):83–6.

No authors. Primary vitamin D deficiency in adults. Drug Ther Bull 2006;44(4):25–9.

Mansoor S, Habib A,Ghani f, Badruddin S, Mansoor S et al. Prevalence and significance of vitamin D deficiency and insufficiency among apparently healthy adults. Clin Biochem 2010;43(18):1431–5.

Vimaleswaran KS, Berry DJ, Lu C, Tikkanen E, Pilz S, Hiraki LT, et al. Causal relationship between obesity and vitamin D status: bi-directional Mendelian randomization analysis of multiple cohorts. PLoS Med 2013;10(2):e1001383.

Hashemipour S, Larijani B, Adibi H, Sedaghat M, Pajouhi M, Bastan-Hagh MH, et al. Status of biochemical parameters in varying degrees of vitamin D deficiency. Bone Miner Metab 2006;24:213–8.

Mass index calculator: [accessed on 11-9-2013]

Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R. Estimates of optimal vitamin D status. (Editorial). Osteopor Int 2005;16(7):713–6.

Mawer EB, Davies M. Vitamin D nutrition and bone disease in adults. Rev Endocr Metab Disord 2001;2(2):153–64.

Kuchuk NO, Pluijm SMF, Van Schoor NM, Looman CWN, Smit JH, Lips P. Relationship of serum 25 hydroxyl vitamin D to bone mineral density and serum parathyroid hormone and markers of bone turnover in older persons. J Clin Endocrinol Metab 2009;94(4):1244–50. [accessed on 6-9-2013] cal & phosphorus. [accessed on 5-9-2013]

Calcitriol. Wikipedia The free encyclopedia. [accessed on 10-9-2013]

Harinarayan CV, Ramalakhshmi T, Vankataprasad U. High prevalence of low dietary calcium and low vitamin D status in healthy South Indians. Asia Pac J Clin Nutr 2004;13(4): 359–64. acid.html# ixzz.2duVDxhct. [accessed on 15-9- 2013] .html#ixzz.2duV3cHVb [accessed on 15-9-2013]

Steingrimsdottir L, Gunnarsson O, Indridason OS, Franzson L, Sigurdsson G. Relationship between serum parathyroid hormone levels, vitamin D sufficiency and calcium intake JAMA. 2005;294(18):2336–41.