High prevalence of vitamin D deficiency among healthy Saudi Arabian men: relationship to bone mineral density, parathyroid hormone, bone turnover markers, and lifestyle factors
- 950 Downloads
In this cross-sectional study, the prevalence of vitamin D deficiency [serum 25-hydroxyvitamin D (25(OH)D) <50 nmol/L] was 87.8% among Saudi Arabian men. There was a linear inverse relationship between serum 25(OH)D and intact parathyroid hormone (PTH) levels, but without a threshold of 25(OH)D at which intact PTH values plateaued.
Vitamin D insufficiency and/or deficiency has now reached epidemic proportions and has been linked to low bone mineral density (BMD), some lifestyle factors, and obesity in adults. This relationship is not well documented in Saudi Arabian men. This study examines the relationship between vitamin D status, intact parathyroid hormone (intact PTH), and lifestyle factors among Saudi Arabian men.
This cross-sectional study involved 834 men aged 20–74 years living in Jeddah area who were randomly selected and medically examined. Men had their BMD (lumbar spine (L1–L4) and neck femur), 25(OH)D, intact PTH, and other parameters measured according to detailed inclusion criteria.
Deficiency (25(OH)D<50 nmol/L) and insufficiency (≥50–75 nmol/L) were present in 87.8% and 9.7%, respectively. Deficiency was common among older and obese men with no education and sedentary lifestyle sampled during summer and spring. Serum 25(OH)D showed an inverse linear relationship with intact PTH, but there was no threshold of serum 25(OH)D at which PTH levels plateaued. There was a positive correlation between BMD values at both lumbar spine (L1–L4) (P < 0.023) and neck femur (P < 0.036) and serum 25(OH)D levels, respectively.
Functionally significant vitamin D deficiency affects BMD and bone turnover markers among Saudi Arabian men and is largely attributed to older age, obesity, sedentary lifestyle, no education, poor exposure to sunlight, smoking, and poor dietary vitamin D supplementation. The data suggest that an increase in PTH cannot be used as a marker for vitamin D deficiency.
KeywordsCalcium intake 25-Hydroxyvitamin D Lifestyle factors Men PTH Saudi Arabs
We are grateful to the Ministry of Higher Education for the financial support to the Center of Excellence for Osteoporosis Research (CEOR) at King Abdulaziz University, (grant nos. CEOR/001-08 and CEOR/004-08) Jeddah, Saudi Arabia. We thank all the subjects who participated in the present study, and we thank all the staff and colleagues at CEOR, King Abdulaziz University Hospital, and the Primary Care Health Centers for their invaluable assistance during the execution of the present study. Special thanks are due to Ms. Veronica Orbacedo for her excellent secretarial help.
Conflicts of interest
- 12.O’Neill TW, Cooper C, Cannata JB, Loper JB, Hoszowski K, Johnell O, Lorenc RS, Nilsson B, Raspe H, Stewart O, Silman AJ (1994) Reproducibility of a questionnaire on risk factors for osteoporosis in multicenter prevalence survey: the European Vertebral Osteoporosis Study. Int J Epidemiol 23:559–565PubMedCrossRefGoogle Scholar
- 16.R Development Core Team (2008) R: a language and environment for statistical computing. Available at http://www.r-project.org/Vienna,Austria. Accessed 16 February 2011
- 17.Lips P, Duong T, Oleksik A, Black D, Cumming 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 86:1212–1221PubMedCrossRefGoogle Scholar
- 28.Saadi HF, Nagelkerke N, Benedict S, Qazaq HS, Zilahi E, Mohamadiyeh MK, Al-Suhaili AI (2006) Predictors relationships of serum 25-hydroxyvitamin D concentrations with bone turnover markers, bone mineral density and vitamin D receptor genotypes in Emirati women. Bone 39:1136–1143PubMedCrossRefGoogle Scholar
- 39.Melin AL, Wilske J, Ringertz H, Saaf M (1999) Vitamin D status, parathyroid function and femoral bone density in an elderly Swedish population living at home. Aging (Milano) 11:200–207Google Scholar