Vitamin D Level of Individuals Having Medical Service in a Tertiary Hospital Vitamin D Level of Individuals in the Hospital
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Abstract
OBJECTIVE: This study aimed to investigate the status of vitamin D level, rates of insufficiency and deficiency in individuals seeking medical services in a tertiary hospital.
METHODS: This retrospective study was conducted between October 1, 2022, and December 24, 2023. Inclusion criteria were individuals aged 18 years or older who had sought medical services in our hospital between August 2021 to May 2022. Information such as age, gender, ethnicity, and personal health data including vitamin D level, blood pressure, body mass index, and bone mineral density were collected. The percentages and risk features among the individuals with inadequate vitamin D levels were analyzed.
RESULTS: Among the 2,459 participants, the mean age was 52.0 years (interquartile range [IQR] 40, 67 years). Approximately one third had one or more health disorders (31.1%), with 29.7% being overweight, 10.8% being obese, and 57.3% having high blood pressure. Osteopenia or osteoporosis was found in 33.2%. The median vitamin D level was 26.3 ng/mL (IQR 19.4, 36.0 ng/mL), with 61.8% had inadequate vitamin D levels as insufficiency in 35.2% and deficiency in 26.6%. Univariable analysis revealed the following three features showing significant association with inadequate vitamin D levels: age younger than 60 years (odds ratio [OR] 2.3, p-value < 0.001), Thai ethnicity (OR 1.3, p-value = 0.014), and overweight/obesity (OR 1.3, p-value = 0.002). Multivariable analysis showed that all three features were independent risk factors for inadequate vitamin D levels.
CONCLUSION: This study showed a high percentage of inadequate vitamin D levels among the participants, with insufficiency in approximately one third and deficiency in one fourth. Older people, Thai people, and overweight/obese people were at risk of inadequate vitamin D levels.
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References
Holick MF. Vitamin D deficiency. N Engl J Med 2007;357(3):266-81.
Khammissa RAG, Fourie J, Motswaledi MH, Ballyram R, Lemmer J, Feller L. The biological activities of vitamin D and its receptor in relation to calcium and bone homeostasis, cancer, immune and cardiovascular systems, skin biology, and oral health. Biomed Res Int 2018;2018:9276380.
Umar M, Sastry KS, Chouchane AI. Role of vitamin D beyond the skeletal function: a review of the molecular and clinical studies. Int J Mol Sci 2018;19(6):1618.
Pludowski P, Holick MF, Pilz S, Wagner CL, Hollis BW, Grant WB, et al. Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality-a review of recent evidence. Autoimmun Rev 2013;12(10):976-89.
Amrein K, Scherkl M, Hoffmann M, Neuwersch-Sommeregger S, Köstenberger M, Tmava Berisha A, et al. Vitamin D deficiency 2.0: an update on the current status worldwide. Eur J Clin Nutr 2020;74(11):1498-513.
Thacher TD, Clarke BL. Vitamin D insufficiency. Mayo Clin Proc 2011;86(1):50-60.
Alshahrani F, Aljohani N. Vitamin D: deficiency, sufficiency and toxicity. Nutrients 2013;5(9):3605-16.
Siwamogsatham O, Ongphiphadhanakul B, Tangpricha V. Vitamin D deficiency in Thailand. J Clin Transl Endocrinol 2015;2(1):48-9.
Cui A, Zhang T, Xiao P, Fan Z, Wang H, Zhuang Y. Global and regional prevalence of vitamin D deficiency in population-based studies from 2000 to 2022: a pooled analysis of 7.9 million participants. Front Nutr 2023;10:1070808.
Soontrapa S, Soontrapa S, Bunyaratavej N, Rojanasthien S, Kittimanon N, Lektrakul S. Vitamin D status of Thai premenopausal women. J Med Assoc Thai 2009;92 Suppl5:S17-20.
Chailurkit LO , Aekplakorn W , Ongphiphadhanakul B. Regional variation and determinants of vitamin D status in sunshine-abundant Thailand. BMC Public Health 2011;11:853.
Kruavit A, Chailurkit LO, Thakkinstian A, Sriphrapradang C, Rajatanavin R. Prevalence of vitamin D insufficiency and low bone mineral density in elderly Thai nursing home residents. BMC Geriatr 2012;12:49.
Nimitphong H, Holick MF. Vitamin D status and sun exposure in Southeast Asia. Dermatoendocrinol 2013;5(1):34-7.
Institute of medicine (US) committee to review dietary reference intakes for vitamin D and calcium. Dietary reference intakes for calcium and vitamin D. Washington DC:National Academies Press; 2011.
Darling AL. Vitamin D deficiency in western dwelling South Asian populations: an unrecognised epidemic. Proc Nutr Soc 2020;79(3):259-71.
Mohd Saffian S, Jamil NA, Mohd Tahir NA, Hatah E. Vitamin D insufficiency is high in Malaysia: a systematic review and meta-analysis of studies on vitamin D status in Malaysia. Front Nutr 2022;9:1050745.
Jiang Z, Pu R, Li N, Chen C, Li J, Dai W, et al. High prevalence of vitamin D deficiency in Asia: a systematic review and meta-analysis. Crit Rev Food Sci Nutr 2023;63(19):3602-11.
Wang TY, Wang HW, Jiang MY. Prevalence of vitamin D deficiency and associated risk of all-cause and cause-specific mortality among middle-aged and older adults in the United States. Front Nutr 2023;10:1163737.
Cui A, Xiao P, Ma Y, Fan Z, Zhou F, Zheng J, et al. Prevalence, trend, and predictor analyses of vitamin D deficiency in the US population, 2001-2018. Front Nutr 2022;9:965376.
Ghosh A, S M, Sunny AS, Diwakar L, Issac TG. Prevalence and patterns of vitamin D deficiency and its role in cognitive functioning in a cohort from South India. Sci Rep 2024;14(1):11215.
Siddiqee MH, Bhattacharjee B, Siddiqi UR, MeshbahurRahman M. High prevalence of vitamin D deficiency among the South Asian adults: a systematic review and meta-analysis. BMC Public Health 2021;21(1):1823.
Matsui T, Tanaka K, Yamashita H, Saneyasu KI, Tanaka H, Takasato Y, et al. Food allergy is linked to season of birth, sun exposure, and vitamin D deficiency. Allergol Int 2019;68(2):172-7.
Chailurkit LO, Thongmung N, Vathesatogkit P, Sritara P, Ongphiphadhanakul B. Longitudinal study of vitamin D status among Thai individuals in a sun-abundant country. Public Health Pract (Oxf) 2023;6:100439.
Parva NR, Tadepalli S, Singh P, Qian A, Joshi R, Kandala H, et al. Prevalence of vitamin D deficiency and associated risk factors in the US population (2011-2012). Cureus 2018;10(6):e2741.
Giustina A, Bouillon R, Dawson-Hughes B, Ebeling PR, Lazaretti-Castro M, Lips P, et al. Vitamin D in the older population: a consensus statement. Endocrine 2023;79(1):31-44.
Chailurkit LO, Ongphiphadhanakul B, Aekplakorn W. Update on vitamin D status in sunshine-abundant Thailand, 2019-2020. Nutrition 2023;116:112161.
Parikh SJ, Edelman M, Uwaifo GI, Freedman RJ, Semega-Janneh M, Reynolds J, et al. The relationship between obesity and serum 1,25-dihydroxy vitamin D concentrations in healthy adults. J Clin Endocrinol Metab 2004;89(3):1196-9.
Pourshahidi LK. Vitamin D and obesity: current perspectives and future directions. Proc Nutr Soc 2015;74(2):115-24.
Karampela I, Sakelliou A, Vallianou N, Christodoulatos GS, Magkos F, Dalamaga M. Vitamin D and obesity: current evidence and controversies. Curr Obes Rep 2021;10(2):162-80.
Pludowski P, Holick MF, Pilz S, Wagner CL, Hollis BW, Grant WB, et al. Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality-a review of recent evidence. Autoimmun Rev 2013;12(10):976-89.
Amrein K, Scherkl M, Hoffmann M, Neuwersch-Sommeregger S, Köstenberger M, Tmava Berisha A, et al. Vitamin D deficiency 2.0: an update on the current status worldwide. Eur J Clin Nutr 2020;74(11):1498-513.
Kheiri B, Abdalla A, Osman M, Ahmed S, Hassan M, Bachuwa G. Vitamin D deficiency and risk of cardiovascular diseases: a narrative review. Clin Hypertens 2018;24:9.
Zhang D, Cheng C, Wang Y, Sun H, Yu S, Xue Y, et al. Effect of vitamin D on blood pressure and hypertension in the general population: an update meta-analysis of cohort studies and randomized controlled trials. Prev Chronic Dis 2020;17:E03.
Karadeniz Y, Özpamuk-Karadeniz F, Ahbab S, Ataoğlu E, Can G. Vitamin D deficiency is a potential risk for blood pressure elevation and the development of hypertension. Medicina (Kaunas) 2021;57(12):1297.