Abstract
Summary
Physicians are indoor workers with low sun exposure. The aim of this study was to compare serum 25-hydroxyvitamin D(25(OH)D) levels among hospitalists and community-based physicians. 25(OH)D levels among hospitalist physicians were significantly lower than those among community-based physicians. Hospitalist physicians should be considered for vitamin D deficiency screening and replacement.
Introduction
Vitamin D deficiency is now recognized as a widespread phenomenon, even in a sunny, Mediterranean country such as Israel. Physicians may be vulnerable to low vitamin D levels due to long work hours and lack of sun exposure.
Methods
Forty-three physicians employed in a hospital and 38 physicians who work in the community in Jerusalem were enrolled. Their serum 25(OH)D levels were measured, and a questionnaire was filled to assess the risk of vitamin D deficiency.
Results
Mean serum levels of 25(OH)D among hospitalist physicians were significantly lower than those among community-based physicians (15 ± 6 vs. 19.7 ± 6 ng/ml, respectively; p < 0.00 l). Arab physicians had a lower 25(OH)D level compared to Jewish physicians (18.2 ± 6.6 vs. 11.4 ± 2.7 ng/ml; p < 0.001). After exclusion of Arab physicians from the analysis, 25(OH)D levels remained higher in hospitalist compared to community-based physicians (15.9 ± 6 vs. 20.4 ± 6 ng/ml; p < 0.004). The variables that were significantly linked to low mean serum levels of 25(OH)D were as follows: age, night shifts, daily sun exposure, and ethnic origin.
Conclusion
Hospitalist physicians are at greater risk for low vitamin D levels than community-based physicians.
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References
Melamed ML, Michos ED, Post W, Astor B (2008) 25-Hydroxyvitamin D levels and the risk of mortality in the general population. Arch Intern Med 168:1629–1637. doi:10.1001/archinte.168.15.1629
Autier P, Boniol M, Pizot C, Mullie P (2014) Vitamin D status and ill health: a systematic review. Lancet Diabetes Endocrinol 2:76–89. doi:10.1016/S2213-8587(13)70165-7
Kendrick J, Targher G, Smits G, Choncho M (2009) 25-Hydroxyvitamin D deficiency is independently associated with cardiovascular disease in the Third National Health and Nutrition Examination Survey. Atherosclerosis 205:255–260. doi:10.1016/j.atherosclerosis.2008.10.033
Holick MF (2004) Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr 80:1678S–1688S
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM (2011) Evaluation, treatment, and prevention of vitamin d deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 96:1911–1930. doi:10.1210/jc.2011-0385
Mukamel MN, Weisman Y, Somech R, Eisenberg Z, Landman J, Shapira I, Spirer Z, Jurgenson U (2001) Vitamin D deficiency and insufficiency in Orthodox and non-Orthodox Jewish mothers in Israel. Isr Med Assoc J 3:419–421
Chao YS, Brunel L, Faris P, Veugelers PJ (2013) Vitamin D status of Canadians employed in northern latitudes. Occup Med (Lond) 63:485–493. doi:10.1093/occmed/kqt106
Holick MF (2009) Vitamin D status: measurement, interpretation and clinical application. Ann Epidemiol 19:73–78. doi:10.1016/j.annepidem.2007.12.001
Del Valle HB, Yaktine AL, Taylor CL, Ross AC. (Eds.). (2011). Dietary reference intakes for calcium and vitamin D. National Academies. http://www.iom.edu/vitaminD
Premaor MO, Paludo P, Manica D, Paludo AP, Rossatto ER, Scalco R, Furlanetto TW (2008) Hypovitaminosis D and secondary hyperparathyroidism in resident physicians of a general hospital in southern Brazil. J Endocrinol Invest 31:991–995. doi:10.1007/BF03345637
Haney EM, Stadler D, Bliziotes MM (2005) Vitamin D insufficiency in internal medicine residents. Calcif Tissue Int 76:11–16. doi:10.1007/s00223-004-0025-0
Growdon AS, Camargo CA Jr, Clark S, Hannon M, Mansbach JM (2012) Serum 25-hydroxyvitamin D levels among Boston trainee doctors in winter. Nutrients 4:97–207. doi:10.3390/nu4030197
Tsur A, Feldman BS, Feldhammer I, Hoshen MB, Leibowitz G, Balicer RD (2013) Decreased serum concentrations of 25-hydroxycholecalciferol are associated with increased risk of progression to impaired fasting glucose and diabetes. Diabetes Care 36:1361–1367. doi:10.2337/dc12-1050
Saliba W, Rennert HS, Kershenbaum A, Rennert G (2012) Serum 25(OH)D concentrations in sunny Israel. Osteoporos Int 23:687–694. doi:10.1007/s00198-011-1597-y
Lowenthal MN, Shany S (1994) Osteomalacia among Bedouin women of the Negev. Isr J Med Sci 30:520–523
Tsur A, Metzger M, Dresner-Pollak R (2011) Effect of different dress style on vitamin D level in healthy young Orthodox and ultra-Orthodox students in Israel. Osteoporos Int 22(11):2895–2898. doi:10.1007/s00198-010-1492-y
Azizi E, Pavlotsky F, Vered I, Kudish AI (2009) Occupational exposure to solar UVB and seasonal monitoring of serum levels of 25-hydroxy vitamin D3: a case-control study. Photochem Photobiol 85:1240–1244. doi:10.1111/j.1751-1097.2009.00569.x
Islam MZ, Shamim AA, Kemi V, Nevanlinna A, Akhtaruzzaman M, Laaksonen M, Jehan AH, Jahan K, Khan HU, Lamberg-Allardt C (2008) Vitamin D deficiency and low bone status in adult female garment factory workers in Bangladesh. Br J Nutr 99:1322–1329. doi:10.1017/S0007114508894445
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We thank Prof. Amos Ynnon for critical review of the article.
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G. Munter and T. Levi-Vineberg equally contributed to this article.
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Munter, G., Levi-Vineberg, T. & Sylvetsky, N. Vitamin D deficiency among physicians: a comparison between hospitalists and community-based physicians. Osteoporos Int 26, 1673–1676 (2015). https://doi.org/10.1007/s00198-015-3028-y
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DOI: https://doi.org/10.1007/s00198-015-3028-y