Increasing trends and significance of hypovitaminosis D: a population-based study in the Kingdom of Saudi Arabia
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Vitamin D deficiency is highly prevalent in Saudi Arabia, particularly among young women and is emerging as public health threat of epidemic proportions. Prevalence of severe hypovitaminosis D is expected to rise exponentially without primary intervention. This largest study encompasses extent of vitamin D deficiency and recommendations to reduce significant health care burden.
The aim of the study was to determine the prevalence and significance of vitamin D deficiency in Saudi population and to help develop national consensus for its prevention, screening, and management.
This was a retrospective observational study which involved 10,709 patients, recruited from the Department of Family Medicine and Polyclinic, King Faisal Specialist Hospital and Research Center (KFSH&RC), Saudi Arabia, over a period of 5 years. The endpoints included overall status of vitamin D level and severity of vitamin D deficiency. Serum measurements included 25 hydroxyvitamin D (25(OH)D), parathormone, calcium, phosphate, alkaline phosphatase, albumin levels, eGFR levels, bone mineral density.
A total of 10,709 patients were analyzed; 31.4 % were males and 68.6 % were females, with a preponderance of Saudis (68.5 %) compared to non-Saudis (31.5 %). The prevalence of vitamin D deficiency was 83.6 % (31.9 % severe, 32.0 % moderate, and 19.7 % mild), when cut points of less than 25, 50, and 75 nmol/l, respectively, were used. Mean serum 25(OH)D was 44.58 ± 34.80 standard deviation (SD) nmol/l. There was significant difference in severity of vitamin D deficiency stratified by age, gender, and nationality. More females had severe 25(OH)D deficiency compared to males (35.6 vs. 23.7 %, p < 0.000). Severe 25(OH)D deficiency was markedly high among adolescents as compared to other age groups (49.2 vs. 30.9 %, p < 0.000). More Saudis were found to be vitamin D deficient compared to non-Saudis (37.2 vs. 20.3 %, p < 0.000).
The prevalence of hypovitaminosis D is significantly high among Saudi population, especially among women, despite abundant sunshine. It is a major public health concern and requires a robust health policy for vitamin D supplementation and implementation of dietary public health measures. Vitamin D screening is strongly recommended at an earlier age especially among women and children.
KeywordsSaudi Arabia Serum 25(OH) D levels Vitamin D deficiency Adolescents
Skillful assistance provided by Ms. Sahar Iqbal in the preparation of this manuscript is gratefully acknowledged by the authors.
Conflicts of interest
Ethical considerations: The research project was conducted in accordance with the guiding principles for experimental procedures written in the Declaration of Helsinki of the World Medical Association, and the NIH Guide for the Care and Use of Laboratory Animals, 1985, contained in the Declaration of Helsinki (2000) and is approved by the institutional review board of KFSH&RC. It complies with the policies of the Research Advisory Committee (RAC) at KFSH&RC and the laws of the Kingdom of Saudi Arabia.
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