Study of serum vitamin D2 and calcium in young and middle aged healthy male smokers in rural tertiary care center

Lalitha Paladugu, Anjaneya P. V., Jayasree Mureboina, Anusha C. Tummala


Background: Smoking is an essential determinant of various diseases. The study is aimed to understand the influence of smoking on serum vitamin D2/D3 levels and serum calcium levels in healthy young/middle-aged men.

Methods: Prospective observational study was done among young and middle-aged healthy male smokers in a rural territory care center. Two hundred patients were studied and analyzed, who fulfill the inclusion and exclusion criteria.

Results:  The prevalence of vitamin D deficiency (25(OH)D <20 ng/ml) was 50.3%. Only 8.8% of the participants had vitamin D sufficiency (25 hydroxyvitamin D ≥30 ng/ml). There is a  strong correlation between 25(OH)D and smoking in the participants (p<0.001). 25 hydroxyvitamin D level was lower by approximately 4.3 ng/ml (p<0.001) in a smoker compared to a non-smoker among the total participants, this value increased to 9.2 ng/ml in the 40-50y subgroup (p=0.003). A multinomial logistic regression model demonstrated that a young smoker (20-29y) had a 58% increased likelihood of having vitamin D deficiency compared to a non-smoker of the same age group (p=0.041). Irrespective of age and chronicity of smoking, there was a significantly increased level of serum calcium and significant vitamin D2/D3 deficiency in smokers.

Conclusion: A high prevalence of vitamin D deficiency was identified in young and middle-aged male smokers, which is not likely to be explained by other confounding lifestyle factors. The depression of the vitamin D-PTH system seen among smokers may represent another potential mechanism for the harmful effects of smoking on the skeleton.


Bone mineral densitometry, Cigarette smokers, Dual X-ray absorptiometry, Vitamin D deficiency, 25-hydroxy vitamin D

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