Vitamin D deficiency and hyperparathyroidism in relation to ethnicity: a cross-sectional survey in healthy adults

European Journal of Nutrition volume 48, pages31–37(2009)Cite this article

Abstract

Background

The study of vitamin D status at population level gained relevance since vitamin D deficiency was recently suggested to trigger chronic disease.

Aim of the study

We aimed to describe vitamin D status, its association with bone and mineral metabolism and risk factors for deficiency in adults over 40 years in Belgium.

Methods

We conducted a cross-sectional survey in a stratified random sample of 401 subjects aged between 40 and 60 years living in Brussels, and drawn from 4 different ethnic backgrounds: autochthonous Belgian, Moroccan, Turkish and Congolese. 25-Hydroxyvitamin D (25OHD), parathyroid hormone (PTH), osteocalcin, C-telopeptide and bone mineral density was measured.

Results

Three-hundred and six subjects (77%) showed 25OHD concentrations below 50 nmol/l,135 (34%) below 25 nmol/l and 18 (5%) below 12.5 nmol/l. The proportion of subjects with vitamin D deficiency was four times greater amongst those of Moroccan or Turkish descent compared with those of Congolese or Belgian descent. Moroccan subjects showed a significant higher PTH and bone marker concentrations compared to Belgian. Ethnicity, season and sex were independently associated with vitamin D deficiency in multivariate analysis.

Conclusion

The prevalence of vitamin D deficiency is very high amongst the adult population of Brussels but immigrants are at greater risk. Given the established link between population health and adequate vitamin D status, a policy of vitamin D supplementation should be considered in these risk groups.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

US$ 39.95

Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3

References

  1. 1.

    Arunabh S, Pollack S, Yeh J, Aloia JF (2003) Body fat content and 25-hydroxyvitamin D levels in healthy women. J Clin Endocrinol Metab 88:157–161

    Article  CAS  Google Scholar 

  2. 2.

    Auwerx J, Bouillon R, Kesteloot H (1992) Relation between 25-hydroxyvitamin D3, apolipoprotein A-I, and high density lipoprotein cholesterol. Arterioscler Thromb 12:671–674

    CAS  Google Scholar 

  3. 3.

    Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B (2006) Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 84:18–28

    CAS  Google Scholar 

  4. 4.

    Bryant RJ, Wastney ME, Martin BR, Wood O, McCabe GP, Morshidi M, Smith DL, Peacock M, Weaver CM (2003) Racial differences in bone turnover and calcium metabolism in adolescent females. J Clin Endocrinol Metab 88:1043–1047

    Article  CAS  Google Scholar 

  5. 5.

    Chapuy MC, Schott AM, Garnero P, Hans D, Delmas PD, Meunier PJ (1996) Healthy elderly French women living at home have secondary hyperparathyroidism and high bone turnover in winter. EPIDOS Study Group. J Clin Endocrinol Metab 81:1129–1133

    Article  CAS  Google Scholar 

  6. 6.

    Chapuy MC, Preziosi P, Maamer M, Arnaud S, Galan P, Hercberg S, Meunier PJ (1997) Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos Int 7:439–443

    Article  CAS  Google Scholar 

  7. 7.

    Chiu KC, Chu A, Go VL, Saad MF (2004) Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr 79:820–825

    CAS  Google Scholar 

  8. 8.

    Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R (2005) Estimates of optimal vitamin D status. Osteoporos Int 16:713–716

    Article  CAS  Google Scholar 

  9. 9.

    Erkal MZ, Wilde J, Bilgin Y, Akinci A, Demir E, Bodeker RH, Mann M, Bretzel RG, Stracke H, Holick MF (2006) High prevalence of vitamin D deficiency, secondary hyperparathyroidism and generalized bone pain in Turkish immigrants in Germany: identification of risk factors. Osteoporos Int 17:1133–1140

    Article  CAS  Google Scholar 

  10. 10.

    Golden MH (1982) Transport proteins as indices of protein status. Am J Clin Nutr 35:1159–1165

    CAS  Google Scholar 

  11. 11.

    Henry YM, Eastell R (2000) Ethnic and gender differences in bone mineral density and bone turnover in young adults: effect of bone size. Osteoporos Int 11:512–517

    Article  CAS  Google Scholar 

  12. 12.

    Holick MF (2004) Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr 79:362–371

    CAS  Google Scholar 

  13. 13.

    Holick MF (2007) Vitamin D deficiency. N Engl J Med 357:266–281

    Article  CAS  Google Scholar 

  14. 14.

    Holick MF, Siris ES, Binkley N, Beard MK, Khan A, Katzer JT, Petruschke RA, Chen E, de Papp AE (2005) Prevalence of vitamin D inadequacy among postmenopausal North American women receiving osteoporosis therapy. J Clin Endocrinol Metab 90:3215–3224

    Article  CAS  Google Scholar 

  15. 15.

    Hypponen E, Laara E, Reunanen A, Jarvelin MR, Virtanen SM (2001) Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet 358:1500–1503

    Article  CAS  Google Scholar 

  16. 16.

    Ingenbleek Y, Young V (1994) Transthyretin (prealbumin) in health and disease: nutritional implications. Annu Rev Nutr 14:495–533

    Article  CAS  Google Scholar 

  17. 17.

    Lamberg-Allardt CJ, Outila TA, Karkkainen MU, Rita HJ, Valsta LM (2001) Vitamin D deficiency and bone health in healthy adults in Finland: could this be a concern in other parts of Europe? J Bone Miner Res 16:2066–2073

    Article  CAS  Google Scholar 

  18. 18.

    Lips P (2004) Which circulating level of 25-hydroxyvitamin D is appropriate? J Steroid Biochem Mol Biol 89–90:611–614

    Article  Google Scholar 

  19. 19.

    Liu PT, Stenger S, Li H, Wenzel L, Tan BH, Krutzik SR, Ochoa MT, Schauber J, Wu K, Meinken C, Kamen DL, Wagner M, Bals R, Steinmeyer A, Zugel U, Gallo RL, Eisenberg D, Hewison M, Hollis BW, Adams JS, Bloom BR, Modlin RL (2006) Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science 311:1770–1773

    Article  CAS  Google Scholar 

  20. 20.

    Malabanan A, Veronikis IE, Holick MF (1998) Redefining vitamin D insufficiency. Lancet 351:805–806

    Article  CAS  Google Scholar 

  21. 21.

    Martins D, Wolf M, Pan D, Zadshir A, Tareen N, Thadhani R, Felsenfeld A, Levine B, Mehrotra R, Norris K (2007) Prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin D in the United States: data from the Third National Health and Nutrition Examination Survey. Arch Intern Med 167:1159–1165

    Article  CAS  Google Scholar 

  22. 22.

    Mathieu C, Gysemans C, Giulietti A, Bouillon R (2005) Vitamin D and diabetes. Diabetologia 48:1247–1257

    Article  CAS  Google Scholar 

  23. 23.

    Matsuoka LY, Wortsman J, Dannenberg MJ, Hollis BW, Lu Z, Holick MF (1992) Clothing prevents ultraviolet-B radiation-dependent photosynthesis of vitamin D3. J Clin Endocrinol Metab 75:1099–1103

    Article  CAS  Google Scholar 

  24. 24.

    Meulmeester JF, van den Berg H, Wedel M, Boshuis PG, Hulshof KF, Luyken R (1990) Vitamin D status, parathyroid hormone and sunlight in Turkish, Moroccan and Caucasian children in The Netherlands. Eur J Clin Nutr 44:461–470

    CAS  Google Scholar 

  25. 25.

    Meyer HE, Falch JA, Sogaard AJ, Haug E (2004) Vitamin D deficiency and secondary hyperparathyroidism and the association with bone mineral density in persons with Pakistani and Norwegian background living in Oslo, Norway, The Oslo Health Study. Bone 35:412–417

    Article  CAS  Google Scholar 

  26. 26.

    Nesby-O’Dell S, Scanlon KS, Cogswell ME, Gillespie C, Hollis BW, Looker AC, Allen C, Doughertly C, Gunter EW, Bowman BA (2002) Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: third National Health and Nutrition Examination Survey, 1988–1994. Am J Clin Nutr 76:187–192

    CAS  Google Scholar 

  27. 27.

    Parfitt AM (1997) Genetic effects on bone mass and turnover-relevance to black/white differences. J Am Coll Nutr 16:325–333

    CAS  Google Scholar 

  28. 28.

    Preece MA, McIntosh WB, Tomlinson S, Ford JA, Dunnigan MG, O’Riordan JL (1973) Vitamin-D deficiency among Asian immigrants to Britain. Lancet 1:907–910

    Article  CAS  Google Scholar 

  29. 29.

    Scragg R, Jackson R, Holdaway IM, Lim T, Beaglehole R (1990) Myocardial infarction is inversely associated with plasma 25-hydroxyvitamin D3 levels: a community-based study. Int J Epidemiol 19:559–563

    Article  CAS  Google Scholar 

  30. 30.

    Snijder MB, van Dam RM, Visser M, Deeg DJ, Dekker JM, Bouter LM, Seidell JC, Lips P (2005) Adiposity in relation to vitamin D status and parathyroid hormone levels: a population-based study in older men and women. J Clin Endocrinol Metab 90:4119–4123

    Article  CAS  Google Scholar 

  31. 31.

    Thomas MK, Lloyd-Jones DM, Thadhani RI, Shaw AC, Deraska DJ, Kitch BT, Vamvakas EC, Dick IM, Prince RL, Finkelstein JS (1998) Hypovitaminosis D in medical inpatients. N Engl J Med 338:777–783

    Article  CAS  Google Scholar 

  32. 32.

    van der Wielen RP, Lowik MR, van den Berg H, de Groot LC, Haller J, Moreiras O, van Staveren WA (1995) Serum vitamin D concentrations among elderly people in Europe. Lancet 346:207–210

    Article  Google Scholar 

  33. 33.

    van der Meer IM, Karamali NS, Boeke AJ, Lips P, Middelkoop BJ, Verhoeven I, Wuister JD (2006) High prevalence of vitamin D deficiency in pregnant non-Western women in The Hague, Netherlands. Am J Clin Nutr 84:350–353

    Google Scholar 

  34. 34.

    Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF (2000) Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 72:690–693

    CAS  Google Scholar 

  35. 35.

    Zittermann A, Schleithoff SS, Koerfer R (2006) Vitamin D insufficiency in congestive heart failure: why and what to do about it? Heart Fail Rev 11:25–33

    Article  CAS  Google Scholar 

Download references

Acknowledgment

This work was supported by the Fonds National de la Recherche Scientifique Médicale (FRSM).

Author information

Affiliations

  1. Dept. of Nuclear Medicine, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070, Brussels, Belgium

    Rodrigo Moreno-Reyes & Serge Goldman

  2. Laboratory for Experimental Surgery L. Deloyers, Université Libre de Bruxelles, Brussels, Belgium

    Yvon A. Carpentier

  3. Epidemiology and Disease Control Unit, Institute of Tropical Medicine, Antwerpen, Belgium

    Marleen Boelaert

  4. Haute Ecole Lucia de Brouckère, Campus CERIA, Brussels, Belgium

    Khadija El Moumni & Ghislaine Dufourny

  5. Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium

    Christine Bazelmans & Alain Levêque

  6. Dept. of Clinical Chemistry, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium

    Christine Gervy

Authors
  1. Rodrigo Moreno-Reyes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yvon A. Carpentier
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marleen Boelaert
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Khadija El Moumni
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ghislaine Dufourny
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Christine Bazelmans
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alain Levêque
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Christine Gervy
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Serge Goldman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rodrigo Moreno-Reyes.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Moreno-Reyes, R., Carpentier, Y.A., Boelaert, M. et al. Vitamin D deficiency and hyperparathyroidism in relation to ethnicity: a cross-sectional survey in healthy adults. Eur J Nutr 48, 31–37 (2009). https://doi.org/10.1007/s00394-008-0756-1

Download citation

Keywords

  • vitamin D
  • ethnicity
  • bone metabolism
  • vitamin D deficiency
  • hyperparathyroidism