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Published in: BMC Endocrine Disorders 1/2018

Open Access 01-12-2018 | Research article

Vitamin D status in healthy black African adults at a tertiary hospital in Nairobi, Kenya: a cross sectional study

Authors: Elizabeth Kagotho, Geoffrey Omuse, Nancy Okinda, Peter Ojwang

Published in: BMC Endocrine Disorders | Issue 1/2018

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Abstract

Background

Vitamin D has been known since the twentieth Century for its benefits in bone health. Recent observational studies have demonstrated its benefits in infectious diseases such as tuberculosis and non-communicable diseases such as diabetes mellitus, cardiovascular diseases and cancer. This has led to a dramatic increase in testing among adults.
The cut-offs for vitamin D deficiency have been debated for decades and the current cut off is derived from a Caucasian population. Studies done among black African adults in Africa are few with vitamin D deficiency ranging from 5 to 91%. A few cut- offs have correlated vitamin D deficiency to physiological markers such as parathyroid hormone (PTH), calcium and phosphate with varying results.

Methods

This was a cross sectional study carried out among blood donors at Aga Khan University hospital, Nairobi (AKUHN) from March to May 2015. Vitamin D (25(OH)D) levels were assayed and correlated with PTH, calcium and phosphate.

Results

A total of 253 individuals were included in the final analysis. The proportion of study participants who had a 25(OH) D level of < 20 ng/ml thus classified as vitamin D deficient was 17.4% (95% C.I 12.73–22.07). The 25(OH) D level that coincided with a significant increase in PTH was 30 ng/ml.
Males were less likely to be vitamin D deficient (O.R 0.48 (C.I 0.233–0.993) p 0.04). Sunshine exposure for ≥3 h per day reduced the odds of being Vitamin D deficient though this was not statistically significant after multivariate regression analysis.

Conclusions

We found a much lower prevalence of Vitamin D deficiency compared to many similar studies carried out in sub-Saharan Africa possibly due to the recruitment of healthy individuals and the proximity of Nairobi to the equator which allows for considerable exposure to sunshine. Vitamin D levels below 30 ng/mL was associated with a significant rise in PTH levels, suggesting that this cut off could be appropriate for defining Vitamin D deficiency in the population served by our laboratory.
Literature
1.
go back to reference Holick MF. Vitamin D: A millenium perspective. J Cell Biochem. 2003;88(2):296–307.CrossRef Holick MF. Vitamin D: A millenium perspective. J Cell Biochem. 2003;88(2):296–307.CrossRef
2.
go back to reference Autier P, Boniol M, Pizot C, Mullie P. Vitamin D status and ill health: a systematic review. Lancet Diabetes Endocrinol. 2014;2(1):76–89.CrossRef Autier P, Boniol M, Pizot C, Mullie P. Vitamin D status and ill health: a systematic review. Lancet Diabetes Endocrinol. 2014;2(1):76–89.CrossRef
3.
go back to reference Chu MP, Alagiakrishnan K, Sadowski C. The cure of ageing: vitamin D--magic or myth? Postgrad Med J. 2010;86(1020):608–16.CrossRef Chu MP, Alagiakrishnan K, Sadowski C. The cure of ageing: vitamin D--magic or myth? Postgrad Med J. 2010;86(1020):608–16.CrossRef
4.
go back to reference Theodoratou E, Tzoulaki I, Zgaga L, Ioannidis JPA. Vitamin D and multiple health outcomes: umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials. BMJ. 2014;348(4):g2035.CrossRef Theodoratou E, Tzoulaki I, Zgaga L, Ioannidis JPA. Vitamin D and multiple health outcomes: umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials. BMJ. 2014;348(4):g2035.CrossRef
5.
go back to reference Krasowski MD. Pathology consultation on vitamin D testing. Am J Clin Pathol. 2011 Oct;136(4):507–14.CrossRef Krasowski MD. Pathology consultation on vitamin D testing. Am J Clin Pathol. 2011 Oct;136(4):507–14.CrossRef
6.
7.
go back to reference Feleke Y, Abdulkadir J, Mshana R, Mekbib T, Brunvand L, Berg JP, et al. Low levels of serum calcidiol in an African population compared to a north European population. Eur J Endocrinol. 1999;21(4):358–60.CrossRef Feleke Y, Abdulkadir J, Mshana R, Mekbib T, Brunvand L, Berg JP, et al. Low levels of serum calcidiol in an African population compared to a north European population. Eur J Endocrinol. 1999;21(4):358–60.CrossRef
8.
go back to reference Luxwolda MF, Kuipers RS, Kema IP, Dijck-brouwer DAJ, Muskiet FAJ. Traditionally living populations in East Africa have a mean serum 25-hydroxyvitamin D concentration of 115 nmol/l. Br J Nutr. 2012;108(9):1557–61.CrossRef Luxwolda MF, Kuipers RS, Kema IP, Dijck-brouwer DAJ, Muskiet FAJ. Traditionally living populations in East Africa have a mean serum 25-hydroxyvitamin D concentration of 115 nmol/l. Br J Nutr. 2012;108(9):1557–61.CrossRef
9.
go back to reference Prentice A, Schoenmakers I, Jones KS, Jarjou LM a, Goldberg GR. Vitamin D deficiency and its health consequences in Africa. Clin Rev Bone Miner Metab. 2009;7(1):94–106.CrossRef Prentice A, Schoenmakers I, Jones KS, Jarjou LM a, Goldberg GR. Vitamin D deficiency and its health consequences in Africa. Clin Rev Bone Miner Metab. 2009;7(1):94–106.CrossRef
10.
go back to reference Arabi A, El Rassi R, El-Hajj Fuleihan G. Hypovitaminosis D in developing countries-prevalence, risk factors and outcomes. Nat Rev Endocrinol. 2010;6(10):550–61.CrossRef Arabi A, El Rassi R, El-Hajj Fuleihan G. Hypovitaminosis D in developing countries-prevalence, risk factors and outcomes. Nat Rev Endocrinol. 2010;6(10):550–61.CrossRef
11.
go back to reference Alshahrani FM, Almalki MH, Aljohani N, Alzahrani A, Alsaleh Y, Holick MF, Vitamin D. Light side and best time of sunshine in Riyadh, Saudi Arabia. Dermatoendocrinol. 2013;5(1):177–80.CrossRef Alshahrani FM, Almalki MH, Aljohani N, Alzahrani A, Alsaleh Y, Holick MF, Vitamin D. Light side and best time of sunshine in Riyadh, Saudi Arabia. Dermatoendocrinol. 2013;5(1):177–80.CrossRef
12.
13.
go back to reference Fitzpatrick TB. The validity and practicality of sun reactive skin types 1 through VI. JAMA dermatology. 1988;124(6):869–71.CrossRef Fitzpatrick TB. The validity and practicality of sun reactive skin types 1 through VI. JAMA dermatology. 1988;124(6):869–71.CrossRef
14.
go back to reference Mayer J, Harris SS. Symposium : optimizing vitamin D intake for populations with special Needs : barriers to effective food fortification and supplementation barriers to optimizing vitamin D 3 intake for the elderly 1. J Nutr. 2006;25(4):1123–5. Mayer J, Harris SS. Symposium : optimizing vitamin D intake for populations with special Needs : barriers to effective food fortification and supplementation barriers to optimizing vitamin D 3 intake for the elderly 1. J Nutr. 2006;25(4):1123–5.
15.
go back to reference Powe CE, Evans MK, Wenger J, Zonderman AB, Berg AH, Nalls M, et al. Vitamin D-binding protein and vitamin D status of black Americans and white Americans. N Engl J Med. 2013;369(21):1991–2000.CrossRef Powe CE, Evans MK, Wenger J, Zonderman AB, Berg AH, Nalls M, et al. Vitamin D-binding protein and vitamin D status of black Americans and white Americans. N Engl J Med. 2013;369(21):1991–2000.CrossRef
16.
go back to reference Hannemann A, Thuesen BH, Friedrich N, Völzke H, Steveling A, Ittermann T, et al. Adiposity measures and vitamin D concentrations in Northeast Germany and Denmark. Nutr Metab (Lond). 2015;12(1):24–33.CrossRef Hannemann A, Thuesen BH, Friedrich N, Völzke H, Steveling A, Ittermann T, et al. Adiposity measures and vitamin D concentrations in Northeast Germany and Denmark. Nutr Metab (Lond). 2015;12(1):24–33.CrossRef
17.
go back to reference Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911–30.CrossRef Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911–30.CrossRef
18.
go back to reference Chapuy MC, Preziosi P, Maamer M, Arnaud S, Galan P, Hercberg S, et al. Prevalence of vitamin D insufficiency in an adult normal population. OsteoporosInt. 1997;7(5):439–43.CrossRef Chapuy MC, Preziosi P, Maamer M, Arnaud S, Galan P, Hercberg S, et al. Prevalence of vitamin D insufficiency in an adult normal population. OsteoporosInt. 1997;7(5):439–43.CrossRef
19.
go back to reference Aspray TJ, Yan L, Prentice A. Parathyroid hormone and rates of bone formation are raised in perimenopausal rural Gambian women. Bone. 2005;36:710–20.CrossRef Aspray TJ, Yan L, Prentice A. Parathyroid hormone and rates of bone formation are raised in perimenopausal rural Gambian women. Bone. 2005;36:710–20.CrossRef
20.
go back to reference Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases , cancers , and cardiovascular disease. Am J Clin Nutr. 2004;80(suppl):1678–88.CrossRef Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases , cancers , and cardiovascular disease. Am J Clin Nutr. 2004;80(suppl):1678–88.CrossRef
Metadata
Title
Vitamin D status in healthy black African adults at a tertiary hospital in Nairobi, Kenya: a cross sectional study
Authors
Elizabeth Kagotho
Geoffrey Omuse
Nancy Okinda
Peter Ojwang
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Endocrine Disorders / Issue 1/2018
Electronic ISSN: 1472-6823
DOI
https://doi.org/10.1186/s12902-018-0296-5

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