**3. Results**

The total number of patients studied was 889; 66% were female of which 77% were Qataris and 34% male, with the mean age of between 75 ± 8.7 years. The upper range of age limit among the study group was 107 years old male (see **Tables 1**–**3** below for results). Sixty per cent of the patients were recruited from Home Healthcare Services (HHS) followed by the out-patient (31.8%) and in-patient (7.2%) departments. Findings identified in terms of percentages were included; 24.4% had stroke (cerebrovascular accident) and 23.65% had coronary artery disease, respectively, 26.25% had dementia, 76.5% had hypertension, 63.2 % had type 2 diabetes and 47.5% dyslipidemia (see **Table 1**).

The Vit D serum level mean baseline utilized was, 24.4 ±13.5 ng/ml; 72% of patients had Vit D deficiency with 31.4 and 29.6% being mildly and moderately deficient, respectively, while 10.8% were severely deficient (see **Table 1**).

As a result, 33.5% of patients were prescribed oral supplementation of Vit D. When tested at the follow-up 6 months later, Vit D levels available in 325 of these patients had increased to 28.5 ± 13.4 (*P* < 0.001).

**Table 2** discusses the rate of recurrence and association of sociodemographic and clinical variables due to Vit D levels.

Vit D deficiency was common in females than males, mildly affected patients female to male percentage was 70.3 vs. 29.7%, moderate 68.5 vs. 31.5% and severe 70 vs. 30%, *P* < 0.91; though, this was not significant. Patients admitted to HHS had notably more Vit D deficiency than other admitting services; mildly affected patients female to male percentage was 54.2 vs. 45.8%, moderate 68.0 vs. 32% and severe 87.5 vs. 15%, *P* < 0.001.

easily adapted for use on a wide range of fully automated microtiter plate readers, making it

Vit D deficiency was defined as level less than 30 ng/ml which was further subdivided into mild (20–29 ng/ml), moderate (10–19 ng/ml) and severe insufficiency (less than 10 ng/ml) [14, 21]. Patient characteristics and outcomes were analysed and compared according to the severity of Vit D deficiency. Patients after 6 months were re-evaluated for Vit D levels and all-cause

Where appropriate, data is presented as proportions, medians or mean ±SD. Wherever applicable the continuous variables were analysed using Student's tests or one-way ANOVA. Also a non-parametric Mann–Whitney test was used for skewed continuous data. Definite variables among groups were compared using the chi-square test; estimating the associations between Vit D deficiency and demographic and clinical index. Age and its correlation with HDL-C, HbA1c and Vitamin D levels was also studied using Pearson's correlation

A two adjusted *P* < 0.05 was considered significant. All data investigation was carried out

The total number of patients studied was 889; 66% were female of which 77% were Qataris and 34% male, with the mean age of between 75 ± 8.7 years. The upper range of age limit among the study group was 107 years old male (see **Tables 1**–**3** below for results). Sixty per cent of the patients were recruited from Home Healthcare Services (HHS) followed by the out-patient (31.8%) and in-patient (7.2%) departments. Findings identified in terms of percentages were included; 24.4% had stroke (cerebrovascular accident) and 23.65% had coronary artery disease, respectively, 26.25% had dementia, 76.5% had hypertension, 63.2 % had

The Vit D serum level mean baseline utilized was, 24.4 ±13.5 ng/ml; 72% of patients had Vit D deficiency with 31.4 and 29.6% being mildly and moderately deficient, respectively, while

As a result, 33.5% of patients were prescribed oral supplementation of Vit D. When tested at the follow-up 6 months later, Vit D levels available in 325 of these patients had increased to

**Table 2** discusses the rate of recurrence and association of sociodemographic and clinical

using the Statistical Package for Social Sciences version 18 (SPSS Inc., USA).

type 2 diabetes and 47.5% dyslipidemia (see **Table 1**).

10.8% were severely deficient (see **Table 1**).

28.5 ± 13.4 (*P* < 0.001).

variables due to Vit D levels.

suitable for use in laboratories of all sizes and with all manner of testing needs'.

mortality.

method.

**3. Results**

**2.4. Statistical analysis**

76 A Critical Evaluation of Vitamin D - Clinical Overview


**Table 1.** Demographics, clinical presentation and outcome in geriatric patients (*n* = 889).



**Table 2.** Comparison of qualitative variables according to vitamin D levels (VDL).

**Vitamin D deficiency** *P*

**Mild (***n* **= 195) Moderate (***n* **= 184) Severe (***n* **= 67)**

Female 126 (72.0%) 137 (70.3%) 126 (68.5%) 47 (70%) 0.912

HHS 66 (42.0%) 91 (54.2%) 102 (68.0%) 49 (87.5%) 0.001

Qatari 135 (79.4%) 146 (77.2%) 133 (75.6%) 49 (76.6%) 0.354

Married 104 (69.8%) 88 (52.0%) 89 (54.0%) 28 (43.8%) 0.008

Diabetes mellitus 107 (61.1%) 128 (65.6%) 124 (67.4%) 46 (68.7%) 0.566 Hypertension 135 (77.1%) 159 (81.5%) 148 (80.4%) 47 (70.1%) 0.217 Dementia 43 (24.6%) 60 (30.8%) 44 (23.9%) 16 (23.9%) 0.388

Heart failure 7 (4.0%) 7 (3.6%) 11 (6.0%) 3 (4.5%) 0.703 Dyslipidaemia 85 (48.6%) 97 (49.7%) 95 (51.6%) 31 (46.3%) 0.879

Hypothyroidism 26 (14.9%) 33 (16.98%) 25 (13.6%) 11 (16.4%) 0.824 Fracture 6 (1%) 5 (7.7%) 9 (16.8%) 5 (14.9%) 0.302 Traumatic 2 (1.1%) 3 (1.5%) 9 (4.9%) 2 (3.0%) 0.100 Social admission 1 (0.6%) 2 (1.0%) 2 (1.1%) 3 (4.5%) 0.101

37 (21.1%) 36 (18.6%) 49 (26.6%) 22 (32.8%) 0.055

24 (13.7%) 15 (2.4%) 31 (5%) 10 (1.6%) 0.055

46 (26.3%) 50 (25.6%) 47 (25.5%) 18 (26.9%) 0.996

5 (2.9%) 3 (1.5%) 4 (2.2%) 3 (4.5%) 0.565

1 (0.6%) 4 (2.1%) 4 (2.2%) 0 (0.0%) 0.376

Male 49 (28%) 58 (29.7%) 58 (31.5%) 20 (30%)

Out patient 67 (42.7%) 55 (32.7%) 34 (22.7%) 5 (9.4%) In-patient 24 (15.3%) 22 (13.1%) 14 (9.3%) 2 (3.6%)

Non-qatari 35 (20.6%) 43 (22.8%) 43 (24.4%) 15 (23.4%)

Non-married 45 (30.2%) 81 (48.0%) 76 (46.0%) 36 (56.2%)

**Optimal VDL (***n* **= 175)**

78 A Critical Evaluation of Vitamin D - Clinical Overview

**Gender**

**Unit**

**Nationality**

**Marital status**

**Diagnosis (on-admission)**

Coronary artery disease

Cerebrovascular accident

Aspiration pneumonia

Urinary tract infection

Renal dysfunction Further it was found that married patients had a considerably higher number of ideal Vit D levels. On admission, diagnoses were compared according to Vit D levels. Proton pump inhibitors *P* < 0.038 and oral Vit D supplementation *P* < 0.003 were prescribed and administered more in Vit D–deficient patients (see **Table 2**).

The mean blood glucose level was noticeably higher in the severe Vit D-deficient group compared to the ideal group 9.5 ± 5 vs. 7.2 ± 3.2 ng/ml, *P* < 0.005. The mean age was compared between the different Vit D–deficient groups, *P* < 0.462 (see **Table 3**).

In patients with T2DM and an estimated glomerular filtration rate (eGFR) \_30 ml/min/1.73 m2 , the mean eGFR was 55.3 ± 8.5 ml/min/1.73 m2 . Note that 55 (19.9%) of those had kidney disease outcomes quality initiative CKD stage 1 disease (eGFR \_90 ml/min/1.73 m2 ), 142 (51.4%) had stage 2 disease (eGFR 60–89 ml/min/1.73 m2 ) and 79 (28.6%) had stage 3 disease (eGFR 30–59 ml/min/1.73 m2 ). There was no considerable link between eGFR in type 2 DM and Vit D levels (*P* = 0.43). No correlation analysis was conducted between Vit D levels and eGFR in nondiabetic patients as the study population was negligible.

**Figures 1** and **2** refer to the connection between Vit D deficiency and HDL-C and HbA1c. There was a positive link noted however between HDL-C and Vit D levels (*r* = 0.173, *P* = 0.001), whereas HbA1c levels indicated a negative association with Vit D levels (*r* = 0.152, *P* = 0.009).


TSH: Thyroid stimulating hormone; ALP: Alkaline Phosphatase; LDL-C: low density lipoprotein cholesterol; HDL-C: High Density lipoprotein cholesterol; all variable are expressed as mean ± standard deviation; T4: Thyroxin; eGFR: estimated glomerular filtration rate.

**Table 3.** Comparison of quantitative variables according to vitamin D levels (VDL).

**Figure 1.** Correlation between HDL-C and vitamin D levels in geriatric patients.

**Vitamin D deficiency** *P*

**Severe (***n* **= 67)**

**(***n* **= 184)**

**Mild (***n* **= 195) Moderate** 

Age (years) 74 ± 8.4 75.3 ± 8.3 74.8 ± 7.6 75.5 ± 9.8 0.462 Body mass index 24.7 ± 5.7 23.1 ± 5.2 26.7 ± 6.5 27.2 ± 7.4 0.263

Vitamin D (ng/ml) 41.2 ± 11.5 24.6 ± 2.9 14.9 ± 2.9 6.5 ± 1.9 0.001 Calcium (mmol/L) 2.3 ± 0.14 2.28 ± 0.12 2.29 ± 0.15 2.26 ± 0.13 0.307

Cholesterol (mmol/L) 4.3 ± 0.9 4.4 ± 0.96 4.5 ± 1.2 4.5 ± 1 0.464 Triglycerides (mmol/L) 1.28 ± 0.65 1.38 ± 1.1 1.45 ± 0.7 1.53 ± 0.9 0.304 TSH (mIU/L) 2.2 ± 1.6 3.9 ± 8.9 3.8 ± 10.2 7.1 ± 17.8 0.081 ALP (IU/L) 82.4 ± 45.1 89.6 ± 57.8 99.3 ± 63.4 105 ± 84 0.049 Glucose (mmol/L) 7.2 ± 3.2 7.7 ± 3.7 8.2 ± 5.1 9.5 ± 5 0.005 HbA1c (%) 7.05 ± 1.5 7.3 ± 1.4 7.2 ± 1.8 8 ± 1.9 0.034 LDL (mmol/L) 2.5 ± 0.73 2.6 ± 0.8 2.7 ± 1 2.8 ± 0.8 0.133 eGFR (ml/minute) 55.3 ± 8.5 47.9 ± 18.1 56.1 ± 6.7 50 ± 17.3 0.432 T4 (ng/L) 18 ± 17.5 16 ± 6.8 13.6 ± 2 12.9 ± 2.8 0.381 Phosphorus (mmol/L) 1.17 ± 0.2 1.2 ± 0.4 1.15 ± 0.3 1.05 ± 0.27 0.118 Parathormone (pmol/L) 96.8 ± 124.3 108.5 ± 105.3 161 ± 164 130.2 ± 104.7 0.212 Haemoglobin (g/dl) 12.1 ± 1.6 12 ± 1.8 12.1 ± 1.9 12.07 ± 1.7 0.959 HDL-C (mmol/L) 1.4 ± 0.9 1.3 ± 0.3 1.2 ± 0.4 1.1 ± 0.4 0.040 Ejection fraction (%) 51.9 ± 11.4 54.4 ± 5.5 53.4 ± 9.6 52.8 ± 8.2 0.916 Albumin (mmol/L) 38.4 ± 6.1 38.5 ± 4.5 38.2 ± 9.9 36.7 ± 5.2 0.344

Vitamin D (2) (ng/ml) 38.2 ± 15.9 26.9 ± 9.4 25.6 ± 11.5 22.3 ± 13.8 0.001

Calcium (mmol/L) 2.28 ± 0.13 2.32 ± 0.37 2.25 ± 0.15 2.27 ± 0.12 0.516 Phosphorus (mmol/L) 1.1 ± 0.25 1.2 ± 0.29 1.2 ± 0.23 1.2 ± 0.26 0.693

**Table 3.** Comparison of quantitative variables according to vitamin D levels (VDL).

TSH: Thyroid stimulating hormone; ALP: Alkaline Phosphatase; LDL-C: low density lipoprotein cholesterol; HDL-C: High Density lipoprotein cholesterol; all variable are expressed as mean ± standard deviation; T4: Thyroxin; eGFR:

104 ± 81.8 122.2 ± 111.4 154.2 ± 171.9 151.7 ± 185.9 0.807

**Baseline Optimal VDL** 

80 A Critical Evaluation of Vitamin D - Clinical Overview

**Follow-up**

(pmol/L)

Parathyroid hormone

estimated glomerular filtration rate.

**(***n* **= 175)**

**Figure 2.** Correlation between type 2 DM patients HbA1c and vitamin D levels in geriatric patients.
