Serum levels of vitamin C and D in adult individuals with diabetes and hypertension compared to healthy controls, and the supplementation tendencies of the vitamins among non-severe COVID-19 patients in Blantyre, Malawi by Dr Kondwani Katundu
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Date
18-10-21
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Kamuzu University of Health Sciencies
Abstract
Executive Summary
Study Title: Serum levels of vitamin C and D in adult individuals with diabetes and
hypertension compared to healthy controls in Blantyre, Malawi.
Study Type: Cross-sectional
Background: Vitamin C and D mitigate the progression of atherosclerosis in individuals
with Diabetes mellitus (DM) and hypertension. DM and hypertension are risks for worse
outcome in COVID-19, and low blood Vitamin C and D associate with the severity of
COVID-19 disease. Vitamin C and D status in healthy controls compared with DM and
hypertension has not been well described in Malawi.
Study Objectives: This study aims to determine the prevalence of serum vitamin C and D
deficiency in adult individuals with diabetes and hypertension in Blantyre, Malawi.
Methods: This will be a cross-sectional where we will analyse serum samples for vitamin
C and D from a cross-sectional study in adult individuals with DM (n=75) and hypertension
(n=75) at QECH and age-matched healthy controls (n=75).
Sample-size: The sample size for the determination of serum vitamin C and D study of
75 participants in each of the three groups (total 225) was calculated to detect at least
15% prevalence of hypovitaminosis in the healthy individuals compared to the individuals
with DM and hypertension, respectively, at a power of 80% and 95% confidence interval.
Outcomes and definitions: The primary outcomes of the study will be the prevalence of
vitamin C and D deficiency and insufficiency in the study population groups. Vitamin C
deficiency and insufficiency will be defined as serum vitamin C concentration of ≤11.4
μmol/L and ≤23.0 - 28 μmol/L respectively. Vitamin D deficiency and insufficiency will be
defined as 25(OH)D of ≤20 ng/ml (50 nmol/L) and ≤21–29 ng/ml respectively.
Expected findings and dissemination: Vitamin C deficiency and insufficiency is prevalent
(up 56%) in low-income countries, and the low fruit intake in most Malawian households
likely predispose individuals to low vitamin C status. We expect low vitamin C status of at
least 20% in the study populations. Low vitamin D status of up to 60% has also been
reported in a recent African review, which did not include data from Malawian adults. We
also expect a positive association between the low vitamin C status with HBA1C,
dyslipidaemia and poorly controlled hypertension. The results once analysed will be
published in an international scientific journal and will be presented both at local and
regional or international conferences. Published results will also be submitted to the
Malawi Liverpool Welcome Trust Clinical Research Programme, College of Medicine
Research and Ethics Committee (COMREC), Kamuzu University of Health Sciences
Library, Blantyre District Health and Social Services Office and Queen Elizabeth Central
Hospital.