Abstract
OBJECTIVE: The precise incidence of vitamin D deficiency is not known, primarily because there is no consensus on the optimal levels of serum 25(OH)Vitamin D. The aim of the present study was to determine the incidence of vitamin D deficiency in a large group of normal adult volunteers residing in a typical temperate region. DESIGN-METHODS: In 625 healthy, free living adults (553 women, 72 men, aged 18–85 years), serum 25(OH)Vitamin D and 1–25(OH)2Vitamin D (RIA), plasma intact PTH (ECL IA) and routine chemistries (multianalyser) were determined at baseline once during a whole year. In a subgroup of 36 subjects, a vitamin D loading (suppression) test was also performed to define the lower normal values for these two Vitamin D metabolites. RESULTS: The estimated lower normal values, based on the results of the vitamin D2 loading test, were 22ng/ml (55nmol/L) for 25(OH)Vitamin D and 24.6pg/ml (59 pmol/l) for 1–25(OH)2Vitamin D. During the whole year, the incidence of low values was 57.7% for 25(OH)Vitamin D and 33.2% for 1–25(OH)2Vitamin D. A highly significant (p<0.001) positive linear correlation of serum 25(OH)Vitamin D with 1–25(OH)2Vitamin D values and a negative correlation of 25(OH)Vitamin D with intact PTH was observed in the entire group and separately in women without or with osteoporosis and osteopenia. CONCL USION: Most of the white normal adults living in a temperate region were vitamin D deficient. The observed correlations between serum concentrations of 25(OH)Vitamin D and 1–25(OH)2Vitamin D as well as of 25(OH)Vitamin D and intact PTH, suggest that 25(OH)Vitamin D is implicated not only in 1–25(OH)2Vitamin D production but also in PTH secretion.
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References
Holick MF, 2007 Vitamin D deficiency. N Engl J Med 357: 266–281.
Holick MF, 2006 High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc 81: 353–373.
Holick MF, Garabedian M 2006 Vitamin D: photobiology, metabolism, mechanism of action and clinical applications. In: Favus MJ, ed. Primer on the metabolic bone diseases and disorders of mineral metabolism. 6th ed. Washington, DC: American Society for Bone and Mineral Research, pp; 129–137.
Thomas MK, Lloyd-Jones DM, Thadhani RI, et al, 1998 Hypovitaminosis D in medical inpatients. N Engl J Med 338: 777–783.
Lips P, Duong T, Oleksik A, et al, 2001 A global study of vitamin D status and parathyroid function in postmenopausal women with osteoporosis: Baseline data from the multiple outcomes of Raloxifene Evaluation Clinical Trial. J Clin Endocrinol Metab 86: 1212–1221.
Chapuy MC, Preziosi P, Maamer M, et al, 1997 Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos Int 7: 439–443.
Malabanan A, Veronikis IE, Holick MF, 1998 Redefining vitamin D insufficiency. Lancet 351: 805–806.
Heaney RP, Dowell MS, Hale CA, Bendich A, 2003 Calcium absorption varies within the reference range for serum 25-hydroxyvitamin D. J Am Coll Nutr 22: 142–146.
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.
Holick MF, 2003 Vitamin D. A millennium perspective. J Cell Biochem 88: 296–307.
Sloka S, Stokes J, Randell E, Newhook LA, 2009 Seasonal variation of maternal serum vitamin D in Newfoundland and Labrador. J Obstel Gynaecol Can 31: 313–321.
Sayre RM, Dowdy JC, 2007 Darkness at noon, sunscreens and vitamin D3 Photochem Photobiol 83: 459–463.
El-Sonbaty MR, Abdul Ghaffar NU, 1996 Vitamin D deficiency in veiled Kuwaiti women. Eur J Clin Nutr 50: 315–318.
Glerup H, Mikkelsen K, Poulsen L, et al, 2000 Commonly recommended daily intake of vitamin D is not sufficient if sunlight exposure is limited. J Intern Med 247: 260–268.
El-Hajj Fuleihan G, Nabusi M, Tamur H, et al, 2001 Hypovitaminosis D in healthy school children. Pediatrics 107: E53.
Marwaha RK, Tandom N, Reddy D, et al, 2005 Vitamin D and bone mineral density status of healthy schoolchildren in northern India. Am J Clin Nutr 82: 477–482.
Van Der Wielen RP, Löwik MR, Van Den Berg H, et al, 1995 Serum vitamin D concentrations among elderly people in Europe. Lancet 346: 207–210.
Papapetrou PD, Triandaphyllopoulou M, Karga H, et al, 2007 Vitamin D deficiency in the elderly in Athens, Greece. J Bone Miner Metab 25: 198–203.
Tangpricha V, Pearce E, Chen J, Holick M, 2002 Vitamin D insufficiency among free-living healthy young adults. Amer J Med 112: 659–662.
Juttmann JR, Visser TJ, Buurman C, de Kam E, Birkenhager JC, 1981 Seasonal fluctuations in serum concentrations of vitamin D metabolites in normal subjects. Brit Med J 282: 1349–1352.
Norman A, 1998 Sunlight, season, skin pigmentation, vitamin D and 25-hydroxyvitamin D: integral components of the vitamin D endocrine system. Am J Clin Nutr 67: 1108–1110.
Levis S, Gomez A, Jimenez C, et al, 2005 Vitamin D deficiency and seasonal variation in an adult south Florida population. J Clin Endocrinol Metab 90: 1557–1562.
Bolland MJ, Grey AB, Ames RW, et al, 2007 The effects of seasonal variation of 25-hydroxyvitamin D and fat mass on a diagnosis of vitamin D sufficiency. Am J Clin Nutr 86: 959–964.
Vieth R, Ladak Y, Walfish PG, 2003 Age-related changes in the 25hydroxyvitamin D versus parathyroid hormone relationship suggest a different reason why older adults require more vitamin D. J Endocrinol Metab 88: 185–191.
Devine A, Wilson SG, Dick IM, Prince RL, 2002 Effects of vitamin D metabolites on intestinal calcium absorption and bone turnover in elderly women. Am J Clin Nutr 75: 283–288.
Brown EM 2010 Control of PTH secretion In: Parathyroids 2010. From pathophysiology to the clinical use of PTH, Pisa, Febr 11–13, 2010, Abstr Book International Symposium, pp; 2–13.
Ichikawa S, Baujat G, Seyahi A, et al, 2010 Clinical variability of familial tumoral calcinosis caused by novel GALNT 3 mutations. Am J Med Genet A 152A: 896–903.
Galitzer H, Ben-Dov I, Lavi-Moshayoff V, et al, 2008 Fibroblast growth factor 23 acts on the parathyroid to decrease parathyroid hormone secretion. Curr Opin Nephrol Hypertens 17: 363–367.
Rejumark L, Vestergaard P, Heickendorff, Mosekilde L, 2008 Plasma 1-25(OH)2Vitamin D levels decrease in postmenopausal women with hypovitaminosis D. Eur J Endocrinol 158: 571–576.
Papapetrou P, 2010 The interrelationship of serum 1–25-dihydroxyvitamin D, 25hydroxyvitamin D and 24,25-dihydroxyvitamin D in pregnancy at term: a meta analysis. Hormones (Athens) 9: 136–144.
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Singhellakis, P.N., Malandrinou, F.C., Psarrou, C.J. et al. Vitamin D deficiency in white, apparently healthy, free-living adults in a temperate region. Hormones 10, 131–143 (2011). https://doi.org/10.14310/horm.2002.1303
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DOI: https://doi.org/10.14310/horm.2002.1303