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Archives of Osteoporosis

, 13:49 | Cite as

Age and gender differences in the prevalence and correlates of vitamin D deficiency

  • AlJohara M. AlQuaiz
  • Ambreen KaziEmail author
  • Mona Fouda
  • Nada Alyousefi
Original Article
  • 147 Downloads

Abstract

Summary

Younger adults and males had a higher prevalence of vitamin D deficiency compared to older participants and females. Low intake of milk, central obesity, and lack of use of vitamin D supplements were associated with vitamin D deficiency, highlighting potentially important avenues for preventive intervention.

Background

Vitamin D deficiency is a public health concern. This study’s objective was to measure the prevalence of vitamin D deficiency and determine its correlates among Saudi adults in Riyadh, Saudi Arabia.

Methods

A cross-sectional study was conducted with 2835 Saudi males and females aged 30–75 years in 18 different primary health care centers (PHCC) in Riyadh. Detailed interviews on sociodemographic and lifestyle factors and anthropometric measurements were conducted. Serum calcium, phosphorus, parathyroid, alkaline phosphatase, and 25(OH) vitamin D were measured. Multiple logistic regression analyses were conducted.

Results

The mean age (SD) of male and female participants was 43.0 (± 11.7) and 42.8 (± 10.3) years, respectively. Serum 25(OH) vitamin D assays for participants revealed that 72.0% (n = 695) of males and 64.0% (n = 1191) of females had levels < 50 nmol/L (deficiency), whereas 17.3% (n = 166) and 19.4% (n = 362), respectively, had levels of 50–75 nmol/L (insufficiency). Multivariate analyses for males revealed that lack of use of vitamin D supplements [adjusted odds ratio (aOR) = 4.0, 95% CI 1.7, 9.4], younger age [30–40 years aOR = 3.6, 95% CI 1.7, 7.3 and 41–50 years aOR = 4.2, 95% CI 2.0, 8.8], low milk intake [aOR = 1.7, 95% CI 1.0, 2.8], consumption of cola drinks [aOR = 2.0, 95% CI 1.1, 3.9], and central obesity [aOR = 1.8, 95% CI 1.0, 3.4] were associated with low vitamin D. In females, lack of use of vitamin D supplements [aOR = 3.7, 95% CI 2.8, 4.9], younger age [30–40 years aOR = 3.4, 95% CI 2.0, 5.8 and 41–50 years aOR = 2.8, 95% CI 1.6, 4.7], central obesity [aOR = 1.4, 95% CI 1.0, 2.2], and seasonal variation [aOR = 1.6, 95% CI 1.3, 2.1] had higher odds for vitamin D deficiency. Significantly lower levels were observed for men than women for mean serum 25(OH) vitamin D [42.6 (± 24.1) vs. 46.8 (± 30.5)], parathyroid hormone [5.3 (± 2.9) vs. 5.9 (± 2.7)], and phosphorus [1.1 (± 0.2) vs. 1.2 (± 0.2)], respectively; alkaline phosphatase levels [106 (± 32.8) vs. 99 (± 27.8)] [p < 0.01] were significantly higher in males than females.

Conclusion

Vitamin D deficiency was highly prevalent, particularly among young adults and those with central obesity. Proper fortification policy, health education, and regular screening PHCCs may help prevent and treat vitamin D deficiency.

Keywords

Vitamin D deficiency Age Gender differences Supplements Carbonated drinks Seasonal variation 

Notes

Acknowledgements

We shall like to thank the Deanship of Research Chairs program, College of Medicine, King Saud University, for facilitating us in conducting this important research. We shall like to acknowledge the Princess Nora Research Chair for Women Health Research for their support and cooperation in conducting this study. We wish to express our appreciation for the efforts of Prof. Ellen B. Gold for reviewing the manuscript and for Mrs Maha Younis and Mr Bushra Abdulwahab for their efforts in supervising the research assistants, collecting the samples, sending it to the lab and arranging other logistics related to the project. We thank all the participants for their time and cooperation.

Authors’ contribution

JAQ conceptualized the study, wrote the proposal, supervised the data collection, and participated in write-up and critical review of the manuscript; AK supervised the training and data collection, conducted the analysis, and participated in the write-up; MF was involved in the proposal writing, conducting the trainings, write-up of discussion, and critical review of the manuscript; NA was involved in the write-up and critical review of the whole manuscript.

Funding

This study was financially supported by the Deanship of Research Chair Program, King Saud University, Riyadh. The funding agency had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.

Compliance with ethical standards

Ethical approval and consent to participate

The study protocol was approved by the Institutional Review Board, King Saud University (E-12-658) and the Institutional Review Board of the Ministry of Health, Dammam (IRB ID MOH0151). Participants were enrolled in the study after they read, understood, and signed the consent form.

Consent for publication

The consent form included statement related to processing and publication of data for a scientific research paper.

Conflicts of interest

None.

References

  1. 1.
    Haq A, Svobodová J, Imran S, Stanford C, Razzaque MS (2016) Vitamin D deficiency: a single centre analysis of patients from 136 countries. J Steroid Biochem Mol Biol 164:209–213CrossRefGoogle Scholar
  2. 2.
    Tuffaha M, El Bcheraoui C, Daoud F, Al Hussaini HA, Alamri F, Al Saeedi M et al (2015) Deficiencies under plenty of sun: vitamin D status among adults in the Kingdom of Saudi Arabia, 2013. N Am J Med Sci 7:467–475CrossRefGoogle Scholar
  3. 3.
    Fields J, Trivedi NJ, Horton E, Mechanick JI (2011) Vitamin D in the Persian Gulf: integrative physiology and socioeconomic factors. Curr Osteoporos Rep 9(4):243–250CrossRefGoogle Scholar
  4. 4.
    Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, IOF Committee of Scientific Advisors (CSA) Nutrition Working Group et al (2009) Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int 20:1807–1820CrossRefGoogle Scholar
  5. 5.
    Hussain AN, Alkhenizan AH, El Shaker M, Raef H, Gabr A (2014) Increasing trends and significance of hypovitaminosis D: a population-based study in the Kingdom of Saudi Arabia. Arch Osteoporos 9:190CrossRefGoogle Scholar
  6. 6.
    Ardawi MS, Qari MH, Rouzi AA, Maimani AA, Raddadi RM (2011) Vitamin D status in relation to obesity, bone mineral density, bone turnover markers and vitamin D receptor genotypes in healthy Saudi pre- and postmenopausal women. Osteoporos Int 22:463–475CrossRefGoogle Scholar
  7. 7.
    Ardawi MS, Sibiany AM, Bakhsh TM, Qari MH, Maimani AA (2012) High prevalence of vitamin D deficiency among healthy Saudi Arabian men: relationship to bone mineral density, parathyroid hormone, bone turnover markers, and lifestyle factors. Osteoporos Int 23:675–686CrossRefGoogle Scholar
  8. 8.
    Alsuwadia AO, Farag YM, Al Sayyari AA, Mousa DH, Alhejaili FF, Al-Harbi AS et al (2013) Prevalence of vitamin D deficiency in Saudi adults. Saudi Med J 34:814–818PubMedGoogle Scholar
  9. 9.
    Alfawaz H, Tamim H, Alharbi S, Aljaser S, Tamimi W (2014) Vitamin D status among patients visiting a tertiary care center in Riyadh, Saudi Arabia: a retrospective review of 3475 cases. BMC Public Health 14:159CrossRefGoogle Scholar
  10. 10.
    Kanan RM, Al Saleh YM, Fakhoury HM, Adham M, Aljaser S, Tamimi W (2013) Year-round vitamin D deficiency among Saudi female out-patients. Public Health Nutr 16:544–548CrossRefGoogle Scholar
  11. 11.
    Sadat-Ali M, Al Elq AH, Al-Turki HA, Al-Mulhim FA, Al-Ali AK (2011) Influence of vitamin D levels on bone mineral density and osteoporosis. Ann Saudi Med 31:602–608CrossRefGoogle Scholar
  12. 12.
    Basit S (2013) Vitamin D in health and disease: a literature review. Br J Biomed Sci 70:161–172CrossRefGoogle Scholar
  13. 13.
    Wacker M, Holick MF (2013) Vitamin D—effects on skeletal and extraskeletal health and the need for supplementation. Nutrients 5:111–148CrossRefGoogle Scholar
  14. 14.
    Nabi G, Hobani Y, Sarwat M (2015) High prevalence of vitamin D deficiency and cancer in Saudi Arabian populations: can we hypothesize a link? Med Hypotheses 85:117–119CrossRefGoogle Scholar
  15. 15.
    Lee PH, Macfarlane DJ, Lam TH, Stewart SM (2011) Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF): a systematic review. Int J Behav Nutr Phys Act 8:115.  https://doi.org/10.1186/1479-5868-8-115 CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Endocrine Society et al (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930CrossRefGoogle Scholar
  17. 17.
    National Health and Nutrition Examination Survey (NHANES). Anthropometry procedure manual. Accessed on January 2014 at https://www.cdc.gov/nchs/data/nhanes/nhanes_07_08/manual_an.pdf
  18. 18.
    World Health Organization (2008) Waist circumference and waist-hip ratio report of a WHO expert consultation Geneva, 8–11 December 2008. Available http://apps.who.int/iris/bitstream/10665/44583/1/9789241501491_eng.pdf
  19. 19.
    Soininen S, Eloranta AM, Lindi V, Venäläinen T, Zaproudina N, Mahonen A, Lakka TA (2016) Determinants of serum 25-hydroxyvitamin D concentration in Finnish children: the Physical Activity and Nutrition in Children (PANIC) study. Br J Nutr 115:1080–1091CrossRefGoogle Scholar
  20. 20.
    Sadat-Ali M, Al Elq A, Al-Farhan M, Sadat NA (2013) Fortification with vitamin D: comparative study in the Saudi Arabian and US markets. J Fam Commun Med 20:49–52CrossRefGoogle Scholar
  21. 21.
    Olson ML, Maalouf NM, Oden JD, White PC, Hutchison MR (2012) Vitamin D deficiency in obese children and its relationship to glucose homeostasis. J Clin Endocrinol Metab 97:279–285CrossRefGoogle Scholar
  22. 22.
    Karonova T, Belyaeva O, Jude EB, Tsiberkin A, Andreeva A, Grineva E et al (2016) Serum 25(OH)D and adipokines levels in people with abdominal obesity. J Steroid Biochem Mol BiolGoogle Scholar
  23. 23.
    Abbas MA (2016) Physiological functions of Vitamin D in adipose tissue. J Steroid Biochem Mol BiolGoogle Scholar
  24. 24.
    Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF (2000) Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 72(3):690–693CrossRefGoogle Scholar
  25. 25.
    Al-Quwaidhi AJ, Pearce MS, Critchley JA, Sobngwi E, O’Flaherty M (2014) Trends and future projections of the prevalence of adult obesity in Saudi Arabia, 1992-2022. East Mediterr Health J 20:589–595CrossRefGoogle Scholar
  26. 26.
    Duchaine CS, Diorio C (2014) Association between intake of sugar-sweetened beverages and circulating 25-hydroxyvitamin D concentration among premenopausal women. Nutrients 6:2987–2999CrossRefGoogle Scholar
  27. 27.
    García-Contreras F, Paniagua R, Avila-Díaz M, Cabrera-Muñoz L, Martínez-Muñiz I, Foyo-Niembro E, Amato D (2000) Cola beverage consumption induces bone mineralization reduction in ovariectomized rats. Arch Med Res 31:360–365CrossRefGoogle Scholar
  28. 28.
    Al Anouti F, Thomas J, Abdel-Wareth L, Rajah J, Grant WB, Haq A (2011) Vitamin D deficiency and sun avoidance among university students at Abu Dhabi, United Arab Emirates. Dermatoendocrinology 3:235–239CrossRefGoogle Scholar
  29. 29.
    Al-Daghri NM, Al-Attas OS, Alokail MS, Alkharfy KM, El-Kholie E, Yousef M et al (2012) Increased vitamin D supplementation recommended during summer season in the gulf region: a counterintuitive seasonal effect in vitamin D levels in adult, overweight and obese Middle Eastern residents. Clin Endocrinol (Oxf) 76:346–350CrossRefGoogle Scholar
  30. 30.
    Jing C, Yun C, He Y, Piao J, Yang L, Yang X (2017) Vitamin D status among the elderly Chinese population: a cross-sectional analysis of the 2010-2013 China National Nutrition and Health Survey (CNNHS). Nutr J 16:3CrossRefGoogle Scholar
  31. 31.
    Schleicher RL, Sternberg MR, Looker AC, Yetley EA, Lacher DA, Sempos CT, Taylor CL, Durazo-Arvizu RA, Maw KL, Chaudhary-Webb M, Johnson CL, Pfeiffer CM (2016) National estimates of serum total 25-hydroxyvitamin D and metabolite concentrations measured by liquid chromatography-tandem mass spectrometry in the US population during 2007–2010. J Nutr 146:1051–1061CrossRefGoogle Scholar
  32. 32.
    Alshahrani FM, Almalki MH, Aljohani N, Alzahrani A, Alsaleh Y, Holick MF (2013) Vitamin D: light side and best time of sunshine in Riyadh, Saudi Arabia. Dermatoendocrinology 5:177–180CrossRefGoogle Scholar
  33. 33.
    Mehboobali N, Iqbal SP, Iqbal MP (2015) High prevalence of vitamin D deficiency and insufficiency in a low income peri-urban community in Karachi. J Pak Med Assoc 65:946–949PubMedGoogle Scholar
  34. 34.
    Wakayo T, Belachew T, Vatanparast H, Whiting SJ (2015) Vitamin D deficiency and its predictors in a country with thirteen months of sunshine: the case of school children in Central Ethiopia. PLoS One 10:e0120963CrossRefGoogle Scholar
  35. 35.
    Sahota O (2000) Osteoporosis and the role of vitamin D and calcium-vitamin D deficiency, vitamin D insufficiency and vitamin D sufficiency. Age Ageing 29(4):301–304 ReviewCrossRefGoogle Scholar
  36. 36.
    Shaheen S, Noor SS, Barakzai Q (2012) Serum alkaline phosphatase screening for vitamin D deficiency states. J Coll Physicians Surg Pak 22(7):424–427. 07.2012/JCPSP.424427Google Scholar
  37. 37.
    Hashemipour S, Larijani B, Adibi H, Sedaghat M, Pajouhi M, Bastan-Hagh MH, Soltani A, Javadi E, Shafaei AR, Baradar-Jalili R, Hossein-Nezhad A (2006) The status of biochemical parameters in varying degrees of vitamin D deficiency. J Bone Miner Metab 24(3):213–218CrossRefGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  • AlJohara M. AlQuaiz
    • 1
    • 2
  • Ambreen Kazi
    • 1
    • 2
    Email author
  • Mona Fouda
    • 1
    • 3
  • Nada Alyousefi
    • 2
  1. 1.Princess Nora Bent Abdallah Chair for Women’s Health Research, Research Chairs program, College of MedicineKing Saud UniversityRiyadhKingdom of Saudi Arabia
  2. 2.Department of Family and Community Medicine, College of MedicineKing Saud UniversityRiyadhKingdom of Saudi Arabia
  3. 3.Department of Endocrinology, College of MedicineKing Saud UniversityRiyadhKingdom of Saudi Arabia

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