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Assessing the effect of dietary calcium intake and 25 OHD status on bone turnover in women in Pakistan

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Abstract

Summary

Bone health assessed in three towns of Karachi, Pakistan in females showed poor calcium intake, vitamin D deficiency, secondary hyperparathyroidism, and high bone turnover. Correlates of high bone turnover included females residing in Saddar Town, underweight females less than 30 years of age from low socio-economic status, and secondary hyperparathyroidism.

Aims

To assess bone health and association of dietary calcium and 25 hydroxy vitamin D with bone turnover in the community-dwelling females of Karachi.

Methods

Bone health was assessed in three randomly selected towns of Karachi, Pakistan. One premenopausal female fulfilling the inclusion criteria from each household was included in the study. Dietary calcium was assessed through a food frequency questionnaire and biochemical markers including calcium, phosphates, albumin, magnesium, creatinine, and SGPT, intact parathyroid hormone, 25 hydroxy vitamin D, and N-telopeptide of type I collagen were measured to assess the bone health.

Results

Three hundred and five females were included from three towns. Overall, 90.5 % of females had vitamin D deficiency with 42.6 and 23.3 % having secondary hyperparathyroidism and high bone turn over respectively. Prevalence of vitamin D deficiency, secondary hyperparathyroidism, and high bone turnover was significantly different among towns. Mean vitamin D levels were significantly low and iPTH levels significantly high in females with high bone turnover. Calcium intake was not significantly different among females with normal, high, and low bone turnover. Correlates of high bone turnover included females residing in Saddar Town, underweight females less than 30 years of age belonging to low socio-economic status, and secondary hyperparathyroidism.

Conclusion

Compromised bone health is seen in community-dwelling females of Karachi. There is a need to perform large-scale community-based studies in all age groups to understand the interplay of markers in our population to understand the impact of these variables translating into the risk of osteoporosis.

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Abbreviations

(VDD):

Vitamin D deficiency

(PTH):

Parathyroid hormone

(iPTH):

Intact parathyroid hormone

(BTM):

Bone turnover marker

(BT):

Bone turnover

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Acknowledgments

The authors are thankful to Miss Maqboola Dojki and Miss Firdaus Shahid for their administrative support and Ms Feroza Nazir and Mr Muhammad Anwar for their support in field work.

Conflicts of Interest

The authors declare that they have no conflicts of interest. The data presented in this manuscript is part of the study “To assess the effect of dietary calcium intake and vitamin D status on bone turnover markers in Pakistani adult females,” which was funded by the Pakistan Science Foundation: Project No. PSF/Res/S-AKU/Med (263). One aspect of this data has been published as “Prevalence of vitamin D deficiency and its correlates: results of a community-based study conducted on Karachi, Pakistan.” Arch Osteoporosis. DOI 10.1007/s11657-012-0108-x. This work was awarded best scientific presentation award at the Pakistan Association of Pathologist meeting held at the College of Physicians and Surgeons Pakistan in December 2011. IOF Young Investigator Award: Determination of bone health status in community-dwelling females in Karachi, Pakistan at International Osteoporosis Foundation Regionals—1st Middle East and Africa Osteoporosis Meeting in Dubai (October 19–22, 2011). Abstract was published in Osteoporosis Int. (2011) 22(Suppl. 5):S689-696.

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Authors and Affiliations

  1. Department of Pathology and Microbiology and Medicine, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan

    Aysha Habib Khan

  2. Department of Pathology and Microbiology, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan

    Ghazala Naureen & Farhan Javed Dar

  3. Department of Community Health Sciences and Medicine, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan

    Romaina Iqbal

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  1. Aysha Habib Khan
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  2. Ghazala Naureen
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  4. Farhan Javed Dar
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Correspondence to Aysha Habib Khan.

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Khan, A.H., Naureen, G., Iqbal, R. et al. Assessing the effect of dietary calcium intake and 25 OHD status on bone turnover in women in Pakistan. Arch Osteoporos 8, 151 (2013). https://doi.org/10.1007/s11657-013-0151-2

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