ASSOCIATED RISK FACTORS OF VITAMIN D DEFICIENCY IN RURAL COMMUNITIES OF LAHORE, PAKISTAN

Abstract

Background: Vitamin D deficiency is a global health concern linked to bone disorders, cardiometabolic diseases, autoimmune conditions, and certain cancers. Despite abundant sunlight, South Asian populations, including Pakistan, have high deficiency rates due to limited sun exposure, cultural practices, and dietary insufficiency. This study aimed to determine the prevalence of severe vitamin D deficiency and its associated risk factors among the rural population of Lahore, Pakistan.

Methods: An analytical cross-sectional study was conducted from December 2023 to June 2024 in rural areas of Lahore. A total of 800 adults (≥18 years) with confirmed vitamin D deficiency (serum 25(OH)D <20 ng/mL) were recruited from outpatient clinics, primary health units, and laboratory collection sites. Data on demographics, sun exposure, and anthropometric measures were collected. Severe deficiency was defined as <10 ng/mL. Frequencies and percentages summarized participant characteristics, and associations between risk factors and severe deficiency were assessed using chi-square tests and multivariable logistic regression.

Results: Of 800 participants, 65.0% were female, and the largest age group was 40–59 years (41.0%). Most (82.0%) were married, and 33.0% worked outside the home. Sun exposure was limited, with 68.6% reporting <1 hour per week; sunscreen use was minimal (3%). Overweight and obesity affected 38.3% and 59.5% respectively. In adjusted analysis, <1 hour of sun exposure per week was associated with more than double the odds of severe deficiency (aOR = 2.38; 95% CI: 1.68–3.38). Obesity (aOR = 1.61; 95% CI: 1.05–2.45) and abdominal obesity in women (aOR = 1.68; 95% CI: 1.10–2.58) were also significant predictors.

Conclusion: Severe vitamin D deficiency is highly prevalent among rural residents of Lahore and is strongly associated with low sun exposure, obesity, and abdominal obesity. Public health strategies promoting safe sunlight exposure, culturally appropriate behavioral changes, and targeted supplementation programs are urgently needed to mitigate the health burden in these communities.

Keywords: Risk Factors, Rural areas, Vitamin D Deficiency