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Osteoporosis International
Published in: Osteoporosis International 12/2016

01-12-2016 | Original Article

Vitamin D deficiency and seasonal variation over the years in São Paulo, Brazil

Authors: M. Eloi, D. V. Horvath, V. L. Szejnfeld, J. C. Ortega, D. A. C. Rocha, J. Szejnfeld, C. H. M. Castro

Published in: Osteoporosis International | Issue 12/2016

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Abstract

Summary

Brazil is a tropical/subtropical geographic area with elevated ultraviolet (UV) radiation. We report very high prevalence of vitamin D deficiency in a large database of Brazilian subjects and show seasonal and reciprocal relationship between vitamin D and parathyroid hormone (PTH) over the years in this tropical area.

Introduction

We aim to examine the prevalence of vitamin D deficiency, characterize the temporal relationship between 25-hydroxyvitamin D levels (25(OH)D) and intact PTH (iPTH) according to seasons, and investigate potential associations between 25(OH)D levels and extra-skeletal outcomes in a Brazilian population.

Methods

We retrospectively determined population weekly mean concentrations of unpaired 25(OH)D and iPTH using 39,004 laboratory results of Brazilian individuals of both genders aged 2 to 95 years. The 25(OH)D and iPTH distributions were normalized, and the means fit with a sinusoidal function. Potential associations between 25(OH)D serum levels and inflammatory markers, fasting glucose, HbA1c and Homeostasis Model Assessment index (HOMA) were examined.

Results

Of the samples, 33.9 % had 25(OH)D serum concentrations lower than 20 ng/mL, while the vast majority (70.7 %) were found to be vitamin D deficient or insufficient (<30 ng/mL). Vitamin D deficiency was significantly higher during the winter as compared to the summer (38.4 % <20 ng/mL and 75.5 % <30 ng/mL versus 23.3 % <20 ng/mL and 62.5 % <30 ng/mL, respectively; p < 0.001). Seasonal variation was observed for both 25(OH)D and iPTH. 25(OH)D peaks occurred in March and troughs in September. iPTH levels showed an inverted pattern of peaks and troughs with a delay of 1 ± 5 week. 25(OH)D was significantly associated with inflammatory markers but not with glucose homeostasis.

Conclusions

A sinusoidal interrelationship has been detected between vitamin D and PTH in this tropical population. A large percentage of the individuals showed vitamin D deficiency. Public health strategies are needed to better understand and manage this very high and apparently contradictory prevalence of vitamin D deficiency.
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Metadata
Title
Vitamin D deficiency and seasonal variation over the years in São Paulo, Brazil
Authors
M. Eloi
D. V. Horvath
V. L. Szejnfeld
J. C. Ortega
D. A. C. Rocha
J. Szejnfeld
C. H. M. Castro
Publication date
01-12-2016
Publisher
Springer London
Published in
Osteoporosis International / Issue 12/2016
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-016-3670-z

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