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Published in: Archives of Osteoporosis 1/2018

01-12-2018 | Original Article

Age and gender differences in the prevalence and correlates of vitamin D deficiency

Authors: AlJohara M. AlQuaiz, Ambreen Kazi, Mona Fouda, Nada Alyousefi

Published in: Archives of Osteoporosis | Issue 1/2018

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Abstract

Summary

Younger adults and males had a higher prevalence of vitamin D deficiency compared to older participants and females. Low intake of milk, central obesity, and lack of use of vitamin D supplements were associated with vitamin D deficiency, highlighting potentially important avenues for preventive intervention.

Background

Vitamin D deficiency is a public health concern. This study’s objective was to measure the prevalence of vitamin D deficiency and determine its correlates among Saudi adults in Riyadh, Saudi Arabia.

Methods

A cross-sectional study was conducted with 2835 Saudi males and females aged 30–75 years in 18 different primary health care centers (PHCC) in Riyadh. Detailed interviews on sociodemographic and lifestyle factors and anthropometric measurements were conducted. Serum calcium, phosphorus, parathyroid, alkaline phosphatase, and 25(OH) vitamin D were measured. Multiple logistic regression analyses were conducted.

Results

The mean age (SD) of male and female participants was 43.0 (± 11.7) and 42.8 (± 10.3) years, respectively. Serum 25(OH) vitamin D assays for participants revealed that 72.0% (n = 695) of males and 64.0% (n = 1191) of females had levels < 50 nmol/L (deficiency), whereas 17.3% (n = 166) and 19.4% (n = 362), respectively, had levels of 50–75 nmol/L (insufficiency). Multivariate analyses for males revealed that lack of use of vitamin D supplements [adjusted odds ratio (aOR) = 4.0, 95% CI 1.7, 9.4], younger age [30–40 years aOR = 3.6, 95% CI 1.7, 7.3 and 41–50 years aOR = 4.2, 95% CI 2.0, 8.8], low milk intake [aOR = 1.7, 95% CI 1.0, 2.8], consumption of cola drinks [aOR = 2.0, 95% CI 1.1, 3.9], and central obesity [aOR = 1.8, 95% CI 1.0, 3.4] were associated with low vitamin D. In females, lack of use of vitamin D supplements [aOR = 3.7, 95% CI 2.8, 4.9], younger age [30–40 years aOR = 3.4, 95% CI 2.0, 5.8 and 41–50 years aOR = 2.8, 95% CI 1.6, 4.7], central obesity [aOR = 1.4, 95% CI 1.0, 2.2], and seasonal variation [aOR = 1.6, 95% CI 1.3, 2.1] had higher odds for vitamin D deficiency. Significantly lower levels were observed for men than women for mean serum 25(OH) vitamin D [42.6 (± 24.1) vs. 46.8 (± 30.5)], parathyroid hormone [5.3 (± 2.9) vs. 5.9 (± 2.7)], and phosphorus [1.1 (± 0.2) vs. 1.2 (± 0.2)], respectively; alkaline phosphatase levels [106 (± 32.8) vs. 99 (± 27.8)] [p < 0.01] were significantly higher in males than females.

Conclusion

Vitamin D deficiency was highly prevalent, particularly among young adults and those with central obesity. Proper fortification policy, health education, and regular screening PHCCs may help prevent and treat vitamin D deficiency.
Literature
1.
go back to reference Haq A, Svobodová J, Imran S, Stanford C, Razzaque MS (2016) Vitamin D deficiency: a single centre analysis of patients from 136 countries. J Steroid Biochem Mol Biol 164:209–213CrossRef Haq A, Svobodová J, Imran S, Stanford C, Razzaque MS (2016) Vitamin D deficiency: a single centre analysis of patients from 136 countries. J Steroid Biochem Mol Biol 164:209–213CrossRef
2.
go back to reference Tuffaha M, El Bcheraoui C, Daoud F, Al Hussaini HA, Alamri F, Al Saeedi M et al (2015) Deficiencies under plenty of sun: vitamin D status among adults in the Kingdom of Saudi Arabia, 2013. N Am J Med Sci 7:467–475CrossRef Tuffaha M, El Bcheraoui C, Daoud F, Al Hussaini HA, Alamri F, Al Saeedi M et al (2015) Deficiencies under plenty of sun: vitamin D status among adults in the Kingdom of Saudi Arabia, 2013. N Am J Med Sci 7:467–475CrossRef
3.
go back to reference Fields J, Trivedi NJ, Horton E, Mechanick JI (2011) Vitamin D in the Persian Gulf: integrative physiology and socioeconomic factors. Curr Osteoporos Rep 9(4):243–250CrossRef Fields J, Trivedi NJ, Horton E, Mechanick JI (2011) Vitamin D in the Persian Gulf: integrative physiology and socioeconomic factors. Curr Osteoporos Rep 9(4):243–250CrossRef
4.
go back to reference Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, IOF Committee of Scientific Advisors (CSA) Nutrition Working Group et al (2009) Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int 20:1807–1820CrossRef Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, IOF Committee of Scientific Advisors (CSA) Nutrition Working Group et al (2009) Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int 20:1807–1820CrossRef
5.
go back to reference Hussain AN, Alkhenizan AH, El Shaker M, Raef H, Gabr A (2014) Increasing trends and significance of hypovitaminosis D: a population-based study in the Kingdom of Saudi Arabia. Arch Osteoporos 9:190CrossRef Hussain AN, Alkhenizan AH, El Shaker M, Raef H, Gabr A (2014) Increasing trends and significance of hypovitaminosis D: a population-based study in the Kingdom of Saudi Arabia. Arch Osteoporos 9:190CrossRef
6.
go back to reference Ardawi MS, Qari MH, Rouzi AA, Maimani AA, Raddadi RM (2011) Vitamin D status in relation to obesity, bone mineral density, bone turnover markers and vitamin D receptor genotypes in healthy Saudi pre- and postmenopausal women. Osteoporos Int 22:463–475CrossRef Ardawi MS, Qari MH, Rouzi AA, Maimani AA, Raddadi RM (2011) Vitamin D status in relation to obesity, bone mineral density, bone turnover markers and vitamin D receptor genotypes in healthy Saudi pre- and postmenopausal women. Osteoporos Int 22:463–475CrossRef
7.
go back to reference Ardawi MS, Sibiany AM, Bakhsh TM, Qari MH, Maimani AA (2012) High prevalence of vitamin D deficiency among healthy Saudi Arabian men: relationship to bone mineral density, parathyroid hormone, bone turnover markers, and lifestyle factors. Osteoporos Int 23:675–686CrossRef Ardawi MS, Sibiany AM, Bakhsh TM, Qari MH, Maimani AA (2012) High prevalence of vitamin D deficiency among healthy Saudi Arabian men: relationship to bone mineral density, parathyroid hormone, bone turnover markers, and lifestyle factors. Osteoporos Int 23:675–686CrossRef
8.
go back to reference Alsuwadia AO, Farag YM, Al Sayyari AA, Mousa DH, Alhejaili FF, Al-Harbi AS et al (2013) Prevalence of vitamin D deficiency in Saudi adults. Saudi Med J 34:814–818PubMed Alsuwadia AO, Farag YM, Al Sayyari AA, Mousa DH, Alhejaili FF, Al-Harbi AS et al (2013) Prevalence of vitamin D deficiency in Saudi adults. Saudi Med J 34:814–818PubMed
9.
go back to reference Alfawaz H, Tamim H, Alharbi S, Aljaser S, Tamimi W (2014) Vitamin D status among patients visiting a tertiary care center in Riyadh, Saudi Arabia: a retrospective review of 3475 cases. BMC Public Health 14:159CrossRef Alfawaz H, Tamim H, Alharbi S, Aljaser S, Tamimi W (2014) Vitamin D status among patients visiting a tertiary care center in Riyadh, Saudi Arabia: a retrospective review of 3475 cases. BMC Public Health 14:159CrossRef
10.
go back to reference Kanan RM, Al Saleh YM, Fakhoury HM, Adham M, Aljaser S, Tamimi W (2013) Year-round vitamin D deficiency among Saudi female out-patients. Public Health Nutr 16:544–548CrossRef Kanan RM, Al Saleh YM, Fakhoury HM, Adham M, Aljaser S, Tamimi W (2013) Year-round vitamin D deficiency among Saudi female out-patients. Public Health Nutr 16:544–548CrossRef
11.
go back to reference Sadat-Ali M, Al Elq AH, Al-Turki HA, Al-Mulhim FA, Al-Ali AK (2011) Influence of vitamin D levels on bone mineral density and osteoporosis. Ann Saudi Med 31:602–608CrossRef Sadat-Ali M, Al Elq AH, Al-Turki HA, Al-Mulhim FA, Al-Ali AK (2011) Influence of vitamin D levels on bone mineral density and osteoporosis. Ann Saudi Med 31:602–608CrossRef
12.
go back to reference Basit S (2013) Vitamin D in health and disease: a literature review. Br J Biomed Sci 70:161–172CrossRef Basit S (2013) Vitamin D in health and disease: a literature review. Br J Biomed Sci 70:161–172CrossRef
13.
go back to reference Wacker M, Holick MF (2013) Vitamin D—effects on skeletal and extraskeletal health and the need for supplementation. Nutrients 5:111–148CrossRef Wacker M, Holick MF (2013) Vitamin D—effects on skeletal and extraskeletal health and the need for supplementation. Nutrients 5:111–148CrossRef
14.
go back to reference Nabi G, Hobani Y, Sarwat M (2015) High prevalence of vitamin D deficiency and cancer in Saudi Arabian populations: can we hypothesize a link? Med Hypotheses 85:117–119CrossRef Nabi G, Hobani Y, Sarwat M (2015) High prevalence of vitamin D deficiency and cancer in Saudi Arabian populations: can we hypothesize a link? Med Hypotheses 85:117–119CrossRef
16.
go back to reference Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Endocrine Society et al (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930CrossRef Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Endocrine Society et al (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930CrossRef
19.
go back to reference Soininen S, Eloranta AM, Lindi V, Venäläinen T, Zaproudina N, Mahonen A, Lakka TA (2016) Determinants of serum 25-hydroxyvitamin D concentration in Finnish children: the Physical Activity and Nutrition in Children (PANIC) study. Br J Nutr 115:1080–1091CrossRef Soininen S, Eloranta AM, Lindi V, Venäläinen T, Zaproudina N, Mahonen A, Lakka TA (2016) Determinants of serum 25-hydroxyvitamin D concentration in Finnish children: the Physical Activity and Nutrition in Children (PANIC) study. Br J Nutr 115:1080–1091CrossRef
20.
go back to reference Sadat-Ali M, Al Elq A, Al-Farhan M, Sadat NA (2013) Fortification with vitamin D: comparative study in the Saudi Arabian and US markets. J Fam Commun Med 20:49–52CrossRef Sadat-Ali M, Al Elq A, Al-Farhan M, Sadat NA (2013) Fortification with vitamin D: comparative study in the Saudi Arabian and US markets. J Fam Commun Med 20:49–52CrossRef
21.
go back to reference Olson ML, Maalouf NM, Oden JD, White PC, Hutchison MR (2012) Vitamin D deficiency in obese children and its relationship to glucose homeostasis. J Clin Endocrinol Metab 97:279–285CrossRef Olson ML, Maalouf NM, Oden JD, White PC, Hutchison MR (2012) Vitamin D deficiency in obese children and its relationship to glucose homeostasis. J Clin Endocrinol Metab 97:279–285CrossRef
22.
go back to reference Karonova T, Belyaeva O, Jude EB, Tsiberkin A, Andreeva A, Grineva E et al (2016) Serum 25(OH)D and adipokines levels in people with abdominal obesity. J Steroid Biochem Mol Biol Karonova T, Belyaeva O, Jude EB, Tsiberkin A, Andreeva A, Grineva E et al (2016) Serum 25(OH)D and adipokines levels in people with abdominal obesity. J Steroid Biochem Mol Biol
23.
go back to reference Abbas MA (2016) Physiological functions of Vitamin D in adipose tissue. J Steroid Biochem Mol Biol Abbas MA (2016) Physiological functions of Vitamin D in adipose tissue. J Steroid Biochem Mol Biol
24.
go back to reference Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF (2000) Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 72(3):690–693CrossRef Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF (2000) Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 72(3):690–693CrossRef
25.
go back to reference Al-Quwaidhi AJ, Pearce MS, Critchley JA, Sobngwi E, O’Flaherty M (2014) Trends and future projections of the prevalence of adult obesity in Saudi Arabia, 1992-2022. East Mediterr Health J 20:589–595CrossRef Al-Quwaidhi AJ, Pearce MS, Critchley JA, Sobngwi E, O’Flaherty M (2014) Trends and future projections of the prevalence of adult obesity in Saudi Arabia, 1992-2022. East Mediterr Health J 20:589–595CrossRef
26.
go back to reference Duchaine CS, Diorio C (2014) Association between intake of sugar-sweetened beverages and circulating 25-hydroxyvitamin D concentration among premenopausal women. Nutrients 6:2987–2999CrossRef Duchaine CS, Diorio C (2014) Association between intake of sugar-sweetened beverages and circulating 25-hydroxyvitamin D concentration among premenopausal women. Nutrients 6:2987–2999CrossRef
27.
go back to reference García-Contreras F, Paniagua R, Avila-Díaz M, Cabrera-Muñoz L, Martínez-Muñiz I, Foyo-Niembro E, Amato D (2000) Cola beverage consumption induces bone mineralization reduction in ovariectomized rats. Arch Med Res 31:360–365CrossRef García-Contreras F, Paniagua R, Avila-Díaz M, Cabrera-Muñoz L, Martínez-Muñiz I, Foyo-Niembro E, Amato D (2000) Cola beverage consumption induces bone mineralization reduction in ovariectomized rats. Arch Med Res 31:360–365CrossRef
28.
go back to reference Al Anouti F, Thomas J, Abdel-Wareth L, Rajah J, Grant WB, Haq A (2011) Vitamin D deficiency and sun avoidance among university students at Abu Dhabi, United Arab Emirates. Dermatoendocrinology 3:235–239CrossRef Al Anouti F, Thomas J, Abdel-Wareth L, Rajah J, Grant WB, Haq A (2011) Vitamin D deficiency and sun avoidance among university students at Abu Dhabi, United Arab Emirates. Dermatoendocrinology 3:235–239CrossRef
29.
go back to reference Al-Daghri NM, Al-Attas OS, Alokail MS, Alkharfy KM, El-Kholie E, Yousef M et al (2012) Increased vitamin D supplementation recommended during summer season in the gulf region: a counterintuitive seasonal effect in vitamin D levels in adult, overweight and obese Middle Eastern residents. Clin Endocrinol (Oxf) 76:346–350CrossRef Al-Daghri NM, Al-Attas OS, Alokail MS, Alkharfy KM, El-Kholie E, Yousef M et al (2012) Increased vitamin D supplementation recommended during summer season in the gulf region: a counterintuitive seasonal effect in vitamin D levels in adult, overweight and obese Middle Eastern residents. Clin Endocrinol (Oxf) 76:346–350CrossRef
30.
go back to reference Jing C, Yun C, He Y, Piao J, Yang L, Yang X (2017) Vitamin D status among the elderly Chinese population: a cross-sectional analysis of the 2010-2013 China National Nutrition and Health Survey (CNNHS). Nutr J 16:3CrossRef Jing C, Yun C, He Y, Piao J, Yang L, Yang X (2017) Vitamin D status among the elderly Chinese population: a cross-sectional analysis of the 2010-2013 China National Nutrition and Health Survey (CNNHS). Nutr J 16:3CrossRef
31.
go back to reference Schleicher RL, Sternberg MR, Looker AC, Yetley EA, Lacher DA, Sempos CT, Taylor CL, Durazo-Arvizu RA, Maw KL, Chaudhary-Webb M, Johnson CL, Pfeiffer CM (2016) National estimates of serum total 25-hydroxyvitamin D and metabolite concentrations measured by liquid chromatography-tandem mass spectrometry in the US population during 2007–2010. J Nutr 146:1051–1061CrossRef Schleicher RL, Sternberg MR, Looker AC, Yetley EA, Lacher DA, Sempos CT, Taylor CL, Durazo-Arvizu RA, Maw KL, Chaudhary-Webb M, Johnson CL, Pfeiffer CM (2016) National estimates of serum total 25-hydroxyvitamin D and metabolite concentrations measured by liquid chromatography-tandem mass spectrometry in the US population during 2007–2010. J Nutr 146:1051–1061CrossRef
32.
go back to reference Alshahrani FM, Almalki MH, Aljohani N, Alzahrani A, Alsaleh Y, Holick MF (2013) Vitamin D: light side and best time of sunshine in Riyadh, Saudi Arabia. Dermatoendocrinology 5:177–180CrossRef Alshahrani FM, Almalki MH, Aljohani N, Alzahrani A, Alsaleh Y, Holick MF (2013) Vitamin D: light side and best time of sunshine in Riyadh, Saudi Arabia. Dermatoendocrinology 5:177–180CrossRef
33.
go back to reference Mehboobali N, Iqbal SP, Iqbal MP (2015) High prevalence of vitamin D deficiency and insufficiency in a low income peri-urban community in Karachi. J Pak Med Assoc 65:946–949PubMed Mehboobali N, Iqbal SP, Iqbal MP (2015) High prevalence of vitamin D deficiency and insufficiency in a low income peri-urban community in Karachi. J Pak Med Assoc 65:946–949PubMed
34.
go back to reference Wakayo T, Belachew T, Vatanparast H, Whiting SJ (2015) Vitamin D deficiency and its predictors in a country with thirteen months of sunshine: the case of school children in Central Ethiopia. PLoS One 10:e0120963CrossRef Wakayo T, Belachew T, Vatanparast H, Whiting SJ (2015) Vitamin D deficiency and its predictors in a country with thirteen months of sunshine: the case of school children in Central Ethiopia. PLoS One 10:e0120963CrossRef
35.
go back to reference Sahota O (2000) Osteoporosis and the role of vitamin D and calcium-vitamin D deficiency, vitamin D insufficiency and vitamin D sufficiency. Age Ageing 29(4):301–304 ReviewCrossRef Sahota O (2000) Osteoporosis and the role of vitamin D and calcium-vitamin D deficiency, vitamin D insufficiency and vitamin D sufficiency. Age Ageing 29(4):301–304 ReviewCrossRef
36.
go back to reference Shaheen S, Noor SS, Barakzai Q (2012) Serum alkaline phosphatase screening for vitamin D deficiency states. J Coll Physicians Surg Pak 22(7):424–427. 07.2012/JCPSP.424427 Shaheen S, Noor SS, Barakzai Q (2012) Serum alkaline phosphatase screening for vitamin D deficiency states. J Coll Physicians Surg Pak 22(7):424–427. 07.2012/JCPSP.424427
37.
go back to reference Hashemipour S, Larijani B, Adibi H, Sedaghat M, Pajouhi M, Bastan-Hagh MH, Soltani A, Javadi E, Shafaei AR, Baradar-Jalili R, Hossein-Nezhad A (2006) The status of biochemical parameters in varying degrees of vitamin D deficiency. J Bone Miner Metab 24(3):213–218CrossRef Hashemipour S, Larijani B, Adibi H, Sedaghat M, Pajouhi M, Bastan-Hagh MH, Soltani A, Javadi E, Shafaei AR, Baradar-Jalili R, Hossein-Nezhad A (2006) The status of biochemical parameters in varying degrees of vitamin D deficiency. J Bone Miner Metab 24(3):213–218CrossRef
Metadata
Title
Age and gender differences in the prevalence and correlates of vitamin D deficiency
Authors
AlJohara M. AlQuaiz
Ambreen Kazi
Mona Fouda
Nada Alyousefi
Publication date
01-12-2018
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2018
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-018-0461-5

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