Approved research

Vitamin D status and Musculoskeletal Health in the UK Biobank: Relationships with Genetic Polymorphisms, Diet, Gender and Lifestyle Factors in South Asian and Caucasian Populations

Lay summary

We will ask the following questions: How much do people?s genes affect how much vitamin D people have, and which genes are the most important influencers of vitamin D? Also, which is more important in determining vitamin D levels, a person?s genes or other factors (e.g. diet, lifestyle, gender, ethnicity)? Adequate vitamin D levels are required for healthy bones, but it is unclear to what degree vitamin D status, diet, gender, lifestyle, ethnicity and genes affect how strong people?s bones are, and how likely they are to get osteoporosis (weak bones) and/or a bone fracture. This study meets the purpose of the UK Biobank as Vitamin D deficiency and fractures are very common, are very debilitating to the person and are costly to the NHS. It has been estimated that eradication of vitamin D deficiency in Western Europe would save society 10,000 million Euros per year1. Hip fracture treatment currently costs the UK £1.9 billion2, even without the very high associated cost of after-care. Therefore, it is in the UK public interest that the above questions are answered, in order that vitamin D deficiency, osteoporosis and associated bone fractures can be prevented. Most scientific research attempting to answer these questions has focussed on White Caucasian women, and there is a lack of data in other ethnic groups, such as South Asian men and women, as well as a lack of data in White Caucasian men. Therefore, in our study we will focus mainly on these understudied groups. We will use mathematical methods to look for patterns in the UK Biobank data to answer the above questions, This research will use data already in the UK Biobank database and so we will not need to access stored biological samples. Subset- All subjects of South Asian ethnicity (Indian, Pakistani, Bangladeshi)and White ethnicity (British/Irish and other White ethnicity).

Scope extension:

We will ask the following questions: How much do peoples genes affect how much vitamin D people have, and which genes are the most important influencers of vitamin D? Also, which is more important in determining vitamin D levels, a person's genes or other factors (e.g. diet, environmental factors, lifestyle, gender, ethnicity)? Adequate vitamin D levels are required for healthy bones, but it is unclear to what degree vitamin D status, diet, gender, lifestyle, ethnicity and genes affect how strong people's bones are, and how likely they are to get osteoporosis (weak bones) and/or a bone fracture. We will also assess whether individuals diagnosed with Ehlers-Danlos Syndrome (EDS) (and associated joint hypermobility syndromes) have lower vitamin D levels than individuals not diagnosed with EDS (or associated joint hypermobility syndromes).In addition to our original analyses we would like to analyse environmental factors (e.g. air pollution, urban-rural factors, aspects of built environment) as a potential influence on vitamin D status- see scope amendment. We would also like to expand our analysis to all ethnic groups in the cohort (not just White and South Asian ethnicity), including an assessment of how poverty/deprivation index is associated with vitamin D levels.

***New scope request 21-9-22 below***

Research question: Is vitamin D intake and vitamin D status associated with levels of C-reactive protein and risk of respiratory tract infections in ethnic subgroups