Prevalence and determinants of vitamin D deficiency in Iranian children and adolescents: the CASPIAN-V study



To examine the prevalence and determinants of vitamin D deficiency in Iranian children and adolescents.


We used data from a national school-based surveillance program conducted among 7-18-year-old children and adolescents living in rural and urban areas in 30 provinces of Iran. Data on student’s lifestyle, health behaviors, and health status was obtained through a validated questionnaire. Serum 25-hydroxy vitamin D (25-OH-D) level was measured by chemiluminescent immunoassay. Vitamin D deficiency was defined as serum 25-OH-D concentrations < 30 ng/ml. Determinants of vitamin D deficiency were identified using logistic regression analysis.


Data of 2,596 participants were available for this study. Prevalence of vitamin D deficiency was 71.1 % (95 % Confidence interval (CI): 69.3–72.8 %), without significant difference between boys and girls (72.0 % vs. 70.1 %, respectively, p = 0.29). In the multivariate regression model, in both genders, those who reported having sun exposure for at least 30 min/day and those taking vitamin D supplementation had lower odds for vitamin D deficiency (all p values < 0.05). In boys, obesity increased the odds of vitamin D deficiency (adjusted OR, 95 % CI: 1.57, 1.08–2.27). The association of vitamin D deficiency with other demographic characteristics and food items was not statistically significant.


This large population-based study revealed a high frequency of hypovitaminosis D in Iranian children and adolescents. Sun exposure for at least 30 min/day and taking vitamin D supplementation may reduce the risk of vitamin D deficiency.

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Data Availability

All the data supporting the findings is contained within the manuscript.


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The authors would like to thank all participants who contributed to this nationwide project. This study was conducted as part of a national surveillance program and was funded by the National Institute for Medical Research Development (Code: 962514).


This study was conducted as part of a national surveillance program and was funded by the National Institute for Medical Research Development (Code: 962514).

Author information




Design: Mostafa Qorbani, Ramin Heshmat, Roya Kelishadi, Mohammad Esmaeil Motlagh.

Study conduct: Mostafa Qorbani, Ramin Heshmat, Roya Kelishadi, Mohammad Esmaeil Motlagh.

Statistical analysis: Mostafa Qorbani, Hadith Rastad.

Paper drafting: Mostafa Qorbani, Hadith Rastad, Hamid Asayesh, Ehsan Seif.

All authors have contributed to revising the manuscript, confirmed the final draft for submission, and accepted the manuscript content’s responsibility.

Corresponding authors

Correspondence to Mostafa Qorbani or Ramin Heshmat.

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Ethics approval and consent to participate

The study was conducted according to the Declaration of Helsinki (Seoul, 2008). Ethical approval was given by the Isfahan University of Medical Sciences ethics committee and other relevant national and provincial regulatory organizations. After a complete explanation of the objectives and protocols, each participant was assured that his/her responses would remain anonymous and confidential. Participation was voluntary, and all potential participants had the right to withdraw from the study at any time. Written informed consent and oral assent were obtained from the parents and students, respectively. 

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Not applicable. 

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The authors declare that they have no competing interests.

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Rastad, H., Mahdavi Gorabi, A., Qorbani, M. et al. Prevalence and determinants of vitamin D deficiency in Iranian children and adolescents: the CASPIAN-V study. J Diabetes Metab Disord (2021).

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  • Vitamin D
  • Obesity
  • Sunlight