Skip to main content

Prevalence and determinants of vitamin D deficiency in healthy French adults: the VARIETE study

Abstract

The U.S. Institute of Medicine considers that a serum 25-hydroxyvitamin D (25OHD) concentration >20 ng/mL corresponds to optimal vitamin D status in the general population. Old studies of vitamin D status in the French general population have demonstrated high prevalence of insufficiency. We measured serum 25OHD, 1,25(OH)2D, PTH, calcium, phosphorus, and creatinine levels in 892 French Caucasian healthy subjects (463 men, 429 women) aged from 18 to 89 years. The 25OHD concentration was similar in men (24.1 ± 8.2 ng/mL) and women (23.4 ± 8.0 ng/mL). 25OHD concentrations of <10, <12, <20, and <30 ng/mL were found in respectively 6.3, 9.9, 34.6, and 80.3 % of subjects. Residence in northern France (odds ratio [OR] 1.91), blood sampling between January and March (OR 7.74), BMI ≥24 kg/m2 (OR 1.81), and age 60 years or more (OR 1.99) were significant determinants of hypovitaminosis D (25OHD <20 ng/mL). The serum 25OHD level correlated positively with 1,25(OH)2D and negatively with PTH. 25OHD values below 20 ng/mL were associated with lower 1,25(OH)2D levels, and 25OHD values below 27 ng/mL were associated with higher PTH levels. Many French healthy adults have a 25OHD concentration <20 ng/mL, especially during winter months. Actions to improve the vitamin D status of the French general population are urgently needed.

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

Fig. 1
Fig. 2
Fig. 3

References

  1. M.F. Holick, N.C. Binkley, H.A. Bischoff-Ferrari, C.M. Gordon, D.A. Hanley, R.P. Heaney, M.H. Murad, C.M. Weaver, S. Endocrine, Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab. 96(7), 1911–1930 (2011)

    CAS  Article  PubMed  Google Scholar 

  2. A.C. Ross, J.E. Manson, S.A. Abrams, J.F. Aloia, P.M. Brannon, S.K. Clinton, R.A. Durazo-Arvizu, J.C. Gallagher, R.L. Gallo, G. Jones, C.S. Kovacs, S.T. Mayne, C.J. Rosen, S.A. Shapses, The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J. Clin. Endocrinol. Metab. 96(1), 53–58 (2011)

    CAS  Article  PubMed  Google Scholar 

  3. M.C. Chapuy, P. Preziosi, M. Maamer, S. Arnaud, P. Galan, S. Hercberg, P.J. Meunier, Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos. Int. 7(5), 439–443 (1997)

    CAS  Article  PubMed  Google Scholar 

  4. M. Touvier, M. Deschasaux, M. Montourcy, A. Sutton, N. Charnaux, E. Kesse-Guyot, L.K. Fezeu, P. Latino-Martel, N. Druesne-Pecollo, D. Malvy, P. Galan, S. Hercberg, K. Ezzedine, J.C. Souberbielle, Interpretation of plasma PTH concentrations according to 25OHD status, gender, age, weight status, and calcium intake: importance of the reference values. J. Clin. Endocrinol. Metab. 99(4), 1196–1203 (2014)

    CAS  Article  PubMed  Google Scholar 

  5. M. Vernay, M. Sponga, B. Salanave, A. Oléko, V. Deschamps, A. Malon, K. Castetbon, Statut en vitamine D de la population adulte en France: l’Étude nationale nutrition santé (ENNS, 2006–2007). Bull. Epidemiol. Hebd. 16–17, 189–194 (2012)

    Google Scholar 

  6. J. van Helden, R. Weiskirchen, Experience with the first fully automated chemiluminescence immunoassay for the quantification of 1alpha, 25-dihydroxy-vitamin D. Clin. Chem. Lab. Med. 53(5), 761–770 (2015)

    PubMed  Google Scholar 

  7. J. Hilger, A. Friedel, R. Herr, T. Rausch, F. Roos, D.A. Wahl, D.D. Pierroz, P. Weber, K. Hoffmann, A systematic review of vitamin D status in populations worldwide. Br. J. Nutr. 111(1), 23–45 (2014)

    CAS  Article  PubMed  Google Scholar 

  8. T. Skaaby, L.L. Husemoen, B.H. Thesen, C. Pisinger, A. Hannemann, T. Jorgensen, A. Linneberg, Longitudinal associations between lifestyle and vitamin D: a general population study with repeated vitamin D measurements. Endocrine 51, 342–350 (2016)

    CAS  Article  PubMed  Google Scholar 

  9. E. Klingberg, G. Oleröd, J. Konar, M. Petzold, O. Hammarsten, Seasonal variations in serum 25-hydroxyvitamin D levels in a swedish cohort. Endocrine 49, 800–808 (2015)

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  10. K.D. Cashman, M. Kiely, Tackling inadequate vitamin D intakes within the population: fortification of dairy products with vitamin D may not be enough. Endocrine 51, 38–46 (2016)

    CAS  Article  PubMed  Google Scholar 

  11. N. Binkley, D.C. Krueger, S. Morgan, D. Wiebe, Current status of clinical 25-hydroxyvitamin D measurement: an assessment of between-laboratory agreement. Clin. Chim. Acta 411, 1976–1982 (2010)

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  12. G. Carter, J.L. Berry, E. Gunter, G. Jones, J.C. Jones, H.L. Makin, S. Sufi, M.J. Wheeler, Proficiency testing of 25-hydroxyvitamin D (25-OHD) assays. J. Steroid Biochem. Mol. Biol. 121, 176–179 (2010)

    CAS  Article  PubMed  Google Scholar 

  13. G. Carter, J.C. Jones, J. Shannon, E.L. Williams, G. Jones, M. Kaufmann, C. Sempos, 25-Hydroxyvitamin D assays: potential interference from other circulating vitamin D metabolites. J. Steroid Biochem. Mol. Biol. (2015). doi:10.1016/jsbmb.2015.12.018

    Google Scholar 

  14. H.A. Bischoff-Ferrari, W.C. Willett, E.J. Orav, P. Lips, P.J. Meunier, R.A. Lyons, L. Flicker, J. Wark, R.D. Jackson, J.A. Cauley, H.E. Meyer, M. Pfeifer, K.M. Sanders, H.B. Stahelin, R. Theiler, B. Dawson-Hughes, A pooled analysis of vitamin D dose requirements for fracture prevention. N. Engl. J. Med. 367, 40–49 (2012)

    CAS  Article  PubMed  Google Scholar 

  15. H.A. Bischoff-Ferrari, B. Dawson-Hughes, H.B. Staehelin, J.E. Orav, A.E. Stuck, R. Theiler, J.B. Wong, A. Egli, D.P. Kiel, J. Henschkowski, Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials. BMJ 339, b3692 (2009)

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  16. S. Christakos, M. Hewison, D.G. Gardner, C.L. Wagner, I.N. Sergeev, E. Rutten, A.G. Pittas, R. Boland, L. Ferrucci, D.D. Bikle, Vitamin D: beyond bone. Ann. N. Y. Acad. Sci. 1287, 45–58 (2013)

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  17. L.J. Black, K.M. Seamans, K.D. Cashman, M. Kiely, An updated systematic review and meta-analysis of the efficacy of vitamin D food fortification. J. Nutr. 142(6), 1102–1108 (2012)

    CAS  Article  PubMed  Google Scholar 

  18. K.H. Madsen, L.B. Rasmussen, R. Andersen, C. Molgaard, J. Jakobsen, P.J. Bjerrum, E.W. Andersen, H. Mejborn, I. Tetens, Randomized controlled trial of the effects of vitamin D-fortified milk and bread on serum 25-hydroxyvitamin D concentrations in families in Denmark during winter: the VitmaD study. Am. J. Clin. Nutr. 98(2), 374–382 (2013)

    CAS  Article  PubMed  Google Scholar 

  19. S.J. Whiting, J.P. Bonjour, F.D. Payen, B. Rousseau, Moderate amounts of vitamin D3 in supplements are effective in raising serum 25-hydroxyvitamin D from low baseline levels in adults: a systematic review. Nutrients 7(4), 2311–2323 (2015)

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  20. J.C. Souberbielle, C.L. Benhamou, B. Cortet, M. Rousiere, C. Roux, V. Abitbol, M. Audran, J. Bachetta, O. Beauchet, H. Blain, V. Breuil, K. Briot, P. Brunet, P. Chanson, C. Cormier, M. Courbebaisse, P. Fardellone, D. Fouque, G. Friedlander, J.B. Gauvain, L. Groussin, P. Houillier, W. Jacot, G. Jean, P. Kamenicky, M.H. Lafage-Proust, E. Legrand, F. Levy-Weil, A. Linglart, E. Mallet, C. Marcelli, G. Maruani, F. Montagnon, V. Personne, D. Prie, A. Raynaud-Simon, Y. Rolland, B. Salle, C. Sault, A.M. Schott, E. Thervet, P. Urena-Torres, J.P. Viard, G. Weryha, C. Pierrot-Deseilligny, J. Young, T. Thomas, HAS report on vitamin D measurement: don’t go from an extreme situation to another as extreme situation. Presse Med. 43(1), 5–8 (2014)

    Article  PubMed  Google Scholar 

  21. N.M. van Schoor, P. Lips, Worldwide vitamin D status. Best Pract Res Clin Endocrinol Metab 25(4), 671–680 (2011)

    Article  PubMed  Google Scholar 

  22. J.F. Aloia, S.A. Talwar, S. Pollack, M. Feuerman, J.K. Yeh, Optimal vitamin D status and serum parathyroid hormone concentrations in African American women. Am. J. Clin. Nutr. 84(3), 602–609 (2006)

    CAS  PubMed  PubMed Central  Google Scholar 

  23. P. Patel, M.Z. Mughal, P. Patel, B. Yagnik, N. Kajale, R. Mandlik, V. Khadilkar, S.A. Chiplonkar, S. Phanse, V. Patwardhan, A. Patel, A. Khadilkar, Dietary calcium intake influences the relationship between serum 25-hydroxyvitamin D3 (25OHD) concentration and parathyroid hormone (PTH) concentration. Arch. Dis. Child. 101(4), 316–319 (2015)

    Article  PubMed  Google Scholar 

  24. H.C. Stepman, A. Vanderroost, K. Van Uytfanghe, L.M. Thienpont, Candidate reference measurement procedures for serum 25-hydroxyvitamin D3 and 25-hydroxyvitamin D2 by using isotope-dilution liquid chromatography-tandem mass spectrometry. Clin. Chem. 57(3), 441–448 (2011)

    CAS  Article  PubMed  Google Scholar 

  25. C.T. Sempos, H.W. Vesper, K.W. Phinney, L.M. Thienpont, P.M. Coates, D.S.P. Vitamin, Vitamin D status as an international issue: national surveys and the problem of standardization. Scand. J. Clin. Lab. Invest. Suppl. 243, 32–40 (2012)

    PubMed  Google Scholar 

Download references

Acknowledgments

We thank DiaSorin for its kind donation of the PTH, 1,25(OH)2D, and 25OHD assay kits. We thank the physicians and technicians of the clinical research units that recruited and examined the healthy subjects, and/or collected data.

Funding

This research was supported by a Grant from Programme Hospitalier de Recherche Clinique, French Ministry of Health, No. P081216/IDRCB 2009-A00892-55.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jean-Claude Souberbielle.

Ethics declarations

Conflicts of interest

JCS reports lecture fees and/or travel/hotel expenses from DiaSorin, Roche Diagnostics, Abbott, Amgen, Shire, MSD, Lilly, and Rottapharm; CM reports lecture fees and travel/hotel expenses from DiaSorin; EC is a consultant for IDS and DiaSorin and has received lecture fees from IDS, DiaSorin, Roche, Abbott, and Amgen; SBT and PC have nothing to disclose.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Souberbielle, JC., Massart, C., Brailly-Tabard, S. et al. Prevalence and determinants of vitamin D deficiency in healthy French adults: the VARIETE study. Endocrine 53, 543–550 (2016). https://doi.org/10.1007/s12020-016-0960-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-016-0960-3

Keywords

  • Vitamin D
  • 25-Hydroxyvitamin D
  • Vitamin D deficiency
  • Parathyroid hormone
  • Calcitriol