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01-12-2017 | Original Article

Seasonal variation of serum vitamin D levels in Romania

Authors: Dan Alexandru Niculescu, Cristina Ana Maria Capatina, Roxana Dusceac, Andra Caragheorgheopol, Adina Ghemigian, Catalina Poiana

Published in: Archives of Osteoporosis | Issue 1/2017

Abstract

Summary

We measured serum vitamin D in 8024 Romanian subjects and found a marked seasonal variation with highest levels in September and lowest levels in March. The seasonal variation (early autumn vs. early spring) persisted in all age and sex groups. The prevalence of vitamin D deficiency was very high.

Purpose

Romania is located in Eastern Europe, roughly between 44°N and 48°N latitude. Seasonal variation of serum vitamin D in Romanian subjects is unknown. We assessed the seasonal variation of 25-hydroxy vitamin D [25(OH)D] in Romanian population.

Methods

We retrieved from our endocrinology center database all 25(OH)D measurements between 2012 and 2016. We also evaluated age, sex, diagnosis, and date of blood sampling. The 25(OH)D was measured by two different chemiluminescence or electrochemiluminescence assays.

Results

There were 8024 subjects (median age 50 (37, 62); 1429 men (17.8%)) without a diagnosis of low bone mass (osteopenia or osteoporosis). The median serum 25(OH)D was 18.6 (12.7, 25.4) ng/mL. Of the subjects, 0.73, 14.4, 55.6, and 86.1% had a serum 25(OH)D level below 4, 10, 20, and 30 ng/mL, respectively. Serum 25(OH)D showed a marked seasonal variation with highest levels in September (24.1 [18.3, 30.3] ng/mL) and lowest levels in March (13.5 [9.4, 19.6] ng/mL) (p < 0.001). The seasonal variation (early autumn vs. early spring) persisted in all age and sex groups and was maximal for 21–40 years of age (26.5 (20.8, 33.1) vs. 12.9 (9.7, 17.9) ng/mL) and minimal for >65 years of age (18.6 (13.0, 27.2) vs. 12.7 (7.8, 19.7) ng/mL). Men and women showed similar amplitude of serum 25(OH)D variation.

Conclusion

The prevalence of vitamin D deficiency is high, particularly in the elderly. The data show a strong seasonal variation of serum 25(OH)D in all subgroups of our Romanian population with highest levels in September and lowest levels in March.

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Holick MF (2007) Vitamin D deficiency. N Engl J Med 357(3):266–281. https://doi.org/10.1056/NEJMra070553 CrossRefPubMed

Burgaz A, Akesson A, Oster A, Michaëlsson K, Wolk A (2007) Associations of diet, supplement use, and ultraviolet B radiation exposure with vitamin D status in Swedish women during winter. Am J Clin Nutr 86(5):1399–1404PubMed

Hintzpeter B, Mensink GB, Thierfelder W et al (2008) Vitamin D status and health correlates among German adults. Eur J Clin Nutr 62(9):1079–1089. https://doi.org/10.1038/sj.ejcn.1602825 CrossRefPubMed

Hypponen E, Power C (2007) Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors. Am J Clin Nutr 85(3):860–868PubMed

Andersen R, Molgaard C, Skovgaard LT et al (2005) Teenage girls and elderly women living in northern Europe have low winter vitamin D status. Eur J Clin Nutr 59(4):533–541. https://doi.org/10.1038/sj.ejcn.1602108 CrossRefPubMed

van der Wielen RP, Lowik MR, van den Berg H et al (1995) Serum vitamin D concentrations among elderly people in Europe. Lancet 346(8969):207–210. https://doi.org/10.1016/S0140-6736(95)91266-5 CrossRefPubMed

Capatina C, Carsote M, Caragheorgheopol A, Poiana C, Berteanu M (2014) Vitamin d deficiency in postmenopausal women—biological correlates. Maedica (Buchar) 9(4):316–322

Chirita-Emandi A, Socolov D, Haivas C, Calapiș A, Gheorghiu C, Puiu M (2015) Vitamin D status: a different story in the very young versus the very old Romanian patients. PLoS One 10(5):e0128010. https://doi.org/10.1371/journal.pone.0128010 CrossRefPubMedPubMedCentral

Grigorie D, Sucaliuc A, Ivan M, Neacsu E, Popa O, Diaconescu A (2008) High prevalence of vitamin D deficiency in 1048 Romanian women with postmenopausal osteoporosis. Acta Endocrinol (Buc) 4(1):33–45. https://doi.org/10.4183/aeb.2008.33 CrossRef

10.

Lips P, Duong T, Oleksik A, Black D, Cummings S, Cox D, Nickelsen T (2001) A global study of vitamin D status and parathyroid function in postmenopausal women with osteoporosis: baseline data from the multiple outcomes of raloxifene evaluation clinical trial. J Clin Endocrinol Metab 86(3):1212–1221. https://doi.org/10.1210/jcem.86.3.7327 CrossRefPubMed

11.

McKenna MJ (1992) Differences in vitamin D status between countries in young adults and the elderly. Am J Med 93(1):69–77. https://doi.org/10.1016/0002-9343(92)90682-2 CrossRefPubMed

12.

Spiro A, Buttriss JL (2014) Vitamin D: an overview of vitamin D status and intake in Europe. Nutr Bull 39(4):322–350. https://doi.org/10.1111/nbu.12108 CrossRefPubMedPubMedCentral

13.

Bhattoa HP, Nagy E, More C, Kappelmayer J, Balogh A, Kalina E, Antal-Szalmas P (2013) Prevalence and seasonal variation of hypovitaminosis D and its relationship to bone metabolism in healthy Hungarian men over 50 years of age: the HunMen Study. Osteoporos Int 24(1):179–186. https://doi.org/10.1007/s00198-012-1920-2 CrossRefPubMed

14.

Bhattoa HP, Bettembuk P, Ganacharya S, Balogh A (2004) Prevalence and seasonal variation of hypovitaminosis D and its relationship to bone metabolism in community dwelling postmenopausal Hungarian women. Osteoporos Int 15(6):447–451. https://doi.org/10.1007/s00198-003-1566-1 CrossRefPubMed

15.

Merlo C, Trummler M, Essig S, Zeller A (2015) Vitamin D deficiency in unselected patients from Swiss primary care: a cross-sectional study in two seasons. PLoS One 10(9):e0138613. https://doi.org/10.1371/journal.pone.0138613 CrossRefPubMedPubMedCentral

16.

Papapetrou PD, Triantaphyllopoulou M, Karga H, Zagarelos P, Aloumanis K, Kostakioti E, Vaiopoulos G (2007) Vitamin D deficiency in the elderly in Athens, Greece. J Bone Miner Metab 25(3):198–203. https://doi.org/10.1007/s00774-006-0746-4 CrossRefPubMed

17.

Mezquita-Raya P, Munoz-Torres M, Luna JD et al (2001) Relation between vitamin D insufficiency, bone density, and bone metabolism in healthy postmenopausal women. J Bone Miner Res 16(8):1408–1415. https://doi.org/10.1359/jbmr.2001.16.8.1408 CrossRefPubMed

18.

Holick MF, Chen TC, Lu Z, Sauter E (2007) Vitamin D and skin physiology: a D-lightful story. J Bone Miner Res 22(Suppl 2):V28–V33. https://doi.org/10.1359/jbmr.07s211 CrossRefPubMed

19.

Atli T, Gullu S, Uysal AR, Erdogan G (2005) The prevalence of vitamin D deficiency and effects of ultraviolet light on vitamin D levels in elderly Turkish population. Arch Gerontol Geriatr 40(1):53–60. https://doi.org/10.1016/j.archger.2004.05.006 CrossRefPubMed

20.

Gannage-Yared MH, Chemali R, Yaacoub N et al (2000) Hypovitaminosis D in a sunny country: relation to lifestyle and bone markers. J Bone Miner Res 15(9):1856–1862. https://doi.org/10.1359/jbmr.2000.15.9.1856 CrossRefPubMed

21.

El-Hajj Fuleihan G, Nabulsi M, Choucair M et al (2001) Hypovitaminosis D in healthy schoolchildren. Pediatrics 107(4):E53. https://doi.org/10.1542/peds.107.4.e53 CrossRefPubMed

22.

Krieg MA, Cornuz J, Jacquet AF, Thiébaud D, Burckhardt P (1998) Influence of anthropometric parameters and biochemical markers of bone metabolism on quantitative ultrasound of bone in the institutionalized elderly. Osteoporos Int 8(2):115–120. https://doi.org/10.1007/BF02672506 CrossRefPubMed

23.

Semba RD, Houston DK, Bandinelli S, Sun K, Cherubini A, Cappola AR, Guralnik JM, Ferrucci L (2010) Relationship of 25-hydroxyvitamin D with all-cause and cardiovascular disease mortality in older community-dwelling adults. Eur J Clin Nutr 64(2):203–209. https://doi.org/10.1038/ejcn.2009.140 CrossRefPubMed

24.

Tolppanen AM, Fraser A, Fraser WD, Lawlor DA (2012) Risk factors for variation in 25-hydroxyvitamin D(3) and D(2) concentrations and vitamin D deficiency in children. J Clin Endocrinol Metab 97(4):1202–1210. https://doi.org/10.1210/jc.2011-2516 CrossRefPubMed

25.

Lagunova Z, Porojnicu AC, Lindberg F, Hexeberg S, Moan J (2009) The dependency of vitamin D status on body mass index, gender, age and season. Anticancer Res 29(9):3713–3720PubMed

26.

Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF (2000) Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 72(3):690–693PubMed

27.

Lester E, Skinner RK, Wills MR (1977) Seasonal variation in serum-25-hydroxyvitamin-D in the elderly in Britain. Lancet 1(8019):979–980CrossRefPubMed

28.

MacLaughlin J, Holick MF (1985) Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest 76(4):1536–1538. https://doi.org/10.1172/JCI112134 CrossRefPubMedPubMedCentral

Title: Seasonal variation of serum vitamin D levels in Romania
Authors: Dan Alexandru Niculescu
Cristina Ana Maria Capatina
Roxana Dusceac
Andra Caragheorgheopol
Adina Ghemigian
Catalina Poiana
Publication date: 01-12-2017
Publisher: Springer London
Published in: Archives of Osteoporosis / Issue 1/2017
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-017-0407-3

At a glance: The STEP trials

Springer Medicine

Seasonal variation of serum vitamin D levels in Romania

Abstract

Summary

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Summary

Purpose

Methods

Results

Conclusion

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