Vitamin D deficiency, the urban epidemic: a cross-sectional study from Bhopal, India

P. V. Prakasa Rao, P. V. Siddhartha, Prashant Yeshwante


Background: Vitamin D is a fat-soluble vitamin involved in the regulation of calcium homeostasis and bone health. Vitamin D deficiency results in abnormalities in calcium, phosphorous, and bone metabolism. We undertook a study in our part of the country to register the incidence of the deficiency in our community, and compared Urban and Rural communities to understand the cause of the deficiency.

Methods: This retrospective non-randomised cross-sectional study was carried out on asymptomatic patients undergoing blood tests due to various causes. 257 individuals consented to be part of the study and were divided into Urban (n=143) and Rural (n=114) groups. Incidence of Vitamin D deficiency, and various socio-behavioural parameters were compared.

Results: The prevalence of Vitamin D deficiency was 91.6% in the Urban population and 66.5% in the rural population, which is statistically significant (p<0.00001). This was observed despite the urban group having statistically better nutritional status and lower tobacco consumption.

Conclusions: Vitamin D deficiency is a widespread condition in community. Clinically diagnosed cases represent only the tip of the iceberg. This silent epidemic needs to be addressed with due attention and strong action.


Bhopal, Vitamin D deficiency, Rural, Urban

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Holick MF. Evalua7on, treatment, and preven7on of vitamin D deficiency: an Endocrine Society clinical prac7ce guideline. J Clin Endocrinol Metab. 2011;96:1911-30.

LeFevre M. Screening for vitamin D deficiency in adults: U.S. preven7ve services task force recommenda7on statement. Ann Intern Med. 2015;162:133-41.

Kennel KA et. Vitamin D deficiency in adults: When to test and how to treat. Mayo Clin Proc. 2010; 85:752-8.

Camacho PM, Petak SM, Binkley N. American Association of Clinical Endocrinologists and American College of Endocrinology Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis - 2016. Endocr Pract. 2016;22(Suppl 4):1-42.

Bordelon P. Recogni7on and management of vitamin D deficiency. Am Fam Phys. 2009; 80:841-6.

Meyer M. Diasorin LIASON ® 25 OH Vitamin D TOTAL Premarket Notification. Available from: [Last cited on 2014 Aug 01].

van Schoor NM, Lips P. Worldwide Vitamin D status. Best Pract Res Clin Endocrinol Metab. 2011;25:671-80.

Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, et al. Global Vitamin D status and determinants of hypovitaminosis D. Osteoporos Int. 2009;20:1807-20.

Suryanarayana P, Arlappa N, Sai Santhosh V, Balakrishna N, Lakshmi Rajkumar P, Prasad U, et al. Prevalence of Vitamin D deficiency and its associated factors among the urban elderly population in Hyderabad metropolitan city, South India. Ann Hum Biol. 2018;45:1339.

Kapil U, Pandey RM, Goswami R, Sharma B, Sharma N, Ramakrishnan L, et al. Prevalence of Vitamin D deficiency and associated risk factors among children residing at high altitude in Shimla district, Himachal Pradesh, India. Indian J Endocrinol Metab. 2017;21:178-83.

Chowdhury R, Taneja S, Bhandari N, Sinha B, Upadhyay RP, Bhan MK, et al. Vitamin-D deficiency predicts infections in young North Indian children: A secondary data analysis. PLoS One. 2017;12:e0170509.

Srimani S, Saha I, Chaudhuri D. Prevalence and association of metabolic syndrome and Vitamin D deficiency among postmenopausal women in a rural block of West Bengal, India. PLoS One. 2017;12:e0188331.

Misra P, Srivastava R, Misra A, Kant S, Kardam P, Vikram NK, et al. Vitamin D status of adult females residing in Ballabgarh health and demographic surveillance system: A community-based study. Indian J Public Health. 2017;61:194-8.

Rattan R, Sahoo D, Mahapatra S. Prevalence of Vitamin D deficiency in adults in the coastal regions of Odisha, India. IOSR J Pharm Biol Sci. 2016;11:49-52.

Gunjaliya A, Patil R, Vaza J, Patel H, Maniyar A. Prevalence of Vitamin D deficiency in higher socioeconomical class of Ahemdabad, Gujarat, India. Int J Med Sci Public Health. 2015;4:617-20.

Bachhel R, Singh NR, Sidhu JS. Prevalence of Vitamin D deficiency in North-West Punjab population: A cross-sectional study. Int J Appl Basic Med Res. 2015;5:7-11.

Tandon VR, Sharma S, Mahajan S, Raina K, Mahajan A, Khajuria V, et al. Prevalence of Vitamin D deficiency among Indian menopausal women and its correlation with diabetes: A first Indian cross sectional data. J Midlife Health. 2014;5:121-5.

Agrawal NK, Sharma B. Prevalence of osteoporosis in otherwise healthy Indian males aged 50 years and above. Arch Osteoporos. 2013;8:116.

Harinarayan CV, Sachan A, Reddy PA, Satish KM, Prasad UV, Srivani P, et al. Vitamin D status and bone mineral density in women of reproductive and postmenopausal age groups: A cross-sectional study from South India. J Assoc Physicians India. 2011;59:698-704.

Babu US, Calvo MS. Modern India and the Vitamin D dilemma: Evidence for the need of a national food fortification program. Mol Nutr Food Res. 2010;54:1134-47.

Harinarayan CV, Ramalakshmi T, Prasad UV, Sudhakar D, Srinivasarao PV, Sarma KV, et al. High prevalence of low dietary calcium, high phytate consumption, and Vitamin D deficiency in healthy South Indians. Am J Clin Nutr. 2007;85:1062-7.

Clements MR, Johnson L, Fraser DR. A new mechanism for induced Vitamin D deficiency in calcium deprivation. Nature. 1987;325:62-5.