Vitamin D status indicators in indigenous populations in East Africa
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Sufficient vitamin D status may be defined as the evolutionary established circulating 25-hydroxyvitamin D [25(OH)D] matching our Paleolithic genome.
We studied serum 25(OH)D [defined as 25(OH)D2 + 25(OH)D3] and its determinants in 5 East African ethnical groups across the life cycle: Maasai (MA) and Hadzabe (HA) with traditional life styles and low fish intakes, and people from Same (SA; intermediate fish), Sengerema (SE; high fish), and Ukerewe (UK; high fish). Samples derived from non-pregnant adults (MA, HA, SE), pregnant women (MA, SA, SE), mother–infant couples at delivery (UK), infants at delivery and their lactating mothers at 3 days (MA, SA, SE), and lactating mothers at 3 months postpartum (SA, SE). Erythrocyte docosahexaenoic acid (RBC-DHA) was determined as a proxy for fish intake.
The mean ± SD 25(OH)D of non-pregnant adults and cord serum were 106.8 ± 28.4 and 79.9 ± 26.4 nmol/L, respectively. Pregnancy, delivery, ethnicity (which we used as a proxy for sunlight exposure), RBC-DHA, and age were the determinants of 25(OH)D. 25(OH)D increased slightly with age. RBC-DHA was positively related to 25(OH)D, notably 25(OH)D2. Pregnant MA (147.7 vs. 118.3) and SE (141.9 vs. 89.0) had higher 25(OH)D than non-pregnant counterparts (MA, SE). Infant 25(OH)D at delivery in Ukerewe was about 65 % of maternal 25(OH)D.
Our ancient 25(OH)D amounted to about 115 nmol/L and sunlight exposure, rather than fish intake, was the principal determinant. The fetoplacental unit was exposed to high 25(OH)D, possibly by maternal vitamin D mobilization from adipose tissue, reduced insulin sensitivity, trapping by vitamin D-binding protein, diminished deactivation, or some combination.
Keywords25-Hydroxyvitamin D Evolution East Africa Sunlight exposure Fish intake Pregnancy
We thank NIMR, Tanzania, for their correspondence and help in the writing of our proposal for ethical clearance. We further thank em. Prof. E. R. Boersma, Prof. J. J. M. van Roosmalen, Prof. S. Massawe, Prof. A. Massawe, Prof. G. V. Mann, J. van der Meulen, P. Gunneweg, P. Schwerzel, R. Shaffer, Dr. J. Changalucha, Drs. C. van Rij, Sr. M. J. Voeten, J. Lugalla, G. Msafiri, N. Mchomvu, S. Mazzuki, rafiki Martini, and all other staff, doctors, and nurses from the local hospitals in Tanzania for their help in our project. We thank Dr. M. Volmer, for his statistical and technical assistance and the VSB Foundation and FrieslandCampina (Dr. A. Schaafsma) for their financial support.
Conflict of interest
There are no conflicts of interest.
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