25 HYDROXY-VITAMIN-D LEVEL INVESTIGATION AND MANAGEMENT

CLINICAL AUDIT IN A TERTIARY HOSPITAL IN CENTRAL PAHANG, MALAYSIA

Authors

  • Hwai Jing Eng
  • Shudim Saiful Shahriza
  • Chee Keong See

Keywords:

25 HYDROXY-VITAMIN-D LEVEL, vitamin D, ALP

Abstract

INTRODUCTION/BACKGROUND
The prevalence of vitamin D deficiency in Malaysia in different populations has been quoted to be between 20 to 90%. Adequate vitamin D in food sources, sun exposure, or supplementation are preventative measures for vitamin D deficiency. Vitamin D level screening is limited by resources in government hospitals and targeted screening in highrisk patients are performed. This study was conducted to ascertain the practice of 25-hydroxyvitamin D screening and management of vitamin D deficiency.

METHODOLOGY
All patients with 25-hydroxyvitaminD levels done at the Hospital Sultan Haji Ahmad Shah, Temerloh in 2023 were included. Patient demographic data, clinical profile, 25-hydroxyvitamin D and vitamin D deficiency management were assessed through electronic medical records.

RESULTS
A total of 126 samples of 25-hydroxyvitamin D were done in 2023 for 100 patients. Majority were paediatric patients (65%) and the rest were adult patients (35%). Mean 25-hydroxyvitamin D levels for adult and paediatric patients were 44.5 nmol/L and 99.8 nmol/L respectively. Most of the investigations were for screening of 25-hydroxyvitamin D status (68.6%) while 21.4% were for monitoring of 25-hydroxyvitamin D levels for patients who are already undergoing vitamin D treatment. Common indications for 25-hydroxyvitamin D in paediatric patients included renal disease (24.6%), prematurity (16.9%), hypocalcaemia (9.2%) and high ALP (7.6%). In adult patients, common indications included renal disease (20%), hypocalcaemia (11.4%), hypercalcemia (7.6%) and osteoporosis (7.6%). Vitamin D deficiency was present in 43.1% (n = 28) of paediatric patients and 54.3% (n = 19) of adult patients. Among paediatric patients with vitamin D deficiency, 67.9% (n = 19) were treated with inactivated vitamin D while 25% (n = 7) did not receive any treatment. Among adult patients with vitamin D deficiency, 15.7% (n = 3) were treated with inactivated vitamin D and 42.1% (n = 8) did not receive any treatment.

CONCLUSION
There was a huge discrepancy in the number of 25-hydroxyvitamin D samples sent in adult and paediatric patients, which may indicate lower awareness of vitamin D screening among adult patients. The high proportion of adult patients with vitamin D deficiency who are not optimally managed with vitamin D supplementation reflect the need to standardize and monitor vitamin D treatment in the hospital.

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Author Biographies

Hwai Jing Eng

Endocrine Unit, Department of Medicine, Hospital Sultan Haji Ahmad Shah, Temerloh, Malaysia

Shudim Saiful Shahriza

Endocrine Unit, Department of Medicine, Hospital Sultan Haji Ahmad Shah, Temerloh, Malaysia

Chee Keong See

Endocrine Unit, Department of Medicine, Hospital Sultan Haji Ahmad Shah, Temerloh, Malaysia

References

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Published

2024-07-17

How to Cite

Eng, H. J., Shahriza, S. S., & See, C. K. (2024). 25 HYDROXY-VITAMIN-D LEVEL INVESTIGATION AND MANAGEMENT: CLINICAL AUDIT IN A TERTIARY HOSPITAL IN CENTRAL PAHANG, MALAYSIA. Journal of the ASEAN Federation of Endocrine Societies, 39(S1), 59–60. Retrieved from https://asean-endocrinejournal.org/index.php/JAFES/article/view/4593