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High prevalence of vitamin D deficiency and influencing factors among urban and rural residents in Tianjin, China

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Abstract

Summary

There was a high prevalence of vitamin D deficiency among residents in Tianjin, China, especially among female residents, rural young adults, and elderly individuals. This is the first large-scale study evaluating vitamin D status in Tianjin, China, and we believe that it makes a significant contribution to the literature.

Purpose

Vitamin D deficiency has been documented as a worldwide public health problem. To our knowledge, there has not been any large-scale study on vitamin D status in Tianjin, China. The aim of this study was to investigate vitamin D status among Tianjin residents and to determine influencing factors.

Methods

This is a community-based study, and residents from both urban and rural areas of Tianjin were enrolled. Each participant completed a questionnaire regarding basic characteristics and lifestyle information. Serum 25-hydroxyvitamin D [25(OH)D] levels were statistically analyzed according to sex, age, and region. Other factors associated with vitamin D deficiency were also explored.

Results

A total of 1814 participants were included, with mean serum 25(OH)D level of 49.44 ± 14.9 nmol/L; only 47.63% achieved the optimal (50–125 nmol/L) 25(OH)D level. Serum 25(OH)D levels were higher among male participants than among female participants (53.44 ± 13.94 versus 46.55 ± 14.91 nmol/L, P < 0.05) and among urban participants than among rural participants (50.4 ± 16.32 versus 48.65 ± 13.58 nmol/L, P < 0.05). Serum 25(OH)D levels were significantly higher among the age group of 40–49 years (50.7 ± 17.99 nmol/L) than among the ≥ 70 years (48.45 ± 14.49 nmol/L) or 18–29 years (47.81 ± 13.08 nmol/L) age groups.

Conclusions

There was a high prevalence of vitamin D deficiency/inadequacy among Tianjin residents, especially among female participants, rural young adults, and elderly individuals. Vitamin D supplementation is imperative for these high-risk vitamin D-deficient residents.

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References

  1. Zittermann A, Gummert JF (2010) Nonclassical vitamin D actions. Nutrients 2:408–425

    Article  CAS  PubMed  Google Scholar 

  2. Wang L, Song Y, Manson JE, Pilz S, März W, Michaëlsson K, Lundpvist A, Jassal SK, Barrett-Connor E, Zhang C, Eaton CB, May HT, Anderson JA, Sesso HD (2012) Circulating 25-hydroxy-vitamin D and risk of cardiovascular disease: a meta-analysis of prospective studies. Circ Cardiovasc Qual Outcomes 5:819–829

    Article  CAS  PubMed  Google Scholar 

  3. Nnoaham KE, Clarke A (2008) Low serum vitamin D levels and tuberculosis: a systematic review and meta-analysis. Int J Epidemiol 37:113–119

    Article  Google Scholar 

  4. Costenbader KH, Feskanich D, Benito-Garcia E, Holmes M, Karlson EW, Benito-Garcia E (2008) Vitamin D intake and risks of systemic lupus erythematosus and rheumatoid arthritis in women. Ann Rheum Dis 67:530–535

    Article  CAS  Google Scholar 

  5. Chen P, Li M, Gu X, Liu Y, Li X, Li C, Wang Y, Xie D, Wang F, Yu C, Li J, Chen X, Chu R, Zhu J, Ou Z, Wang H (2013) Higher blood 25(OH)D level may reduce the breast cancer risk: evidence from a Chinese population based case-control study and meta-analysis of the observational studies. PLoS One 8:e49312

    Article  CAS  PubMed  Google Scholar 

  6. Lee JE, Li H, Chan AT (2011) Circulating levels of vitamin D and colon and rectal cancer: the Physicians’ Health Study and a meta-analysis of prospective studies. Cancer Prev Res (Phila) 4:735–743

    Article  CAS  Google Scholar 

  7. Afzal S, Bojesen SE, Nordestgaard BG (2013) Low 25-hydroxyvitamin D and risk of type 2 diabetes: a prospective cohort study and meta-analysis. Clin Chem 59:381–391

    Article  CAS  Google Scholar 

  8. Troesch B, Hoeft B, McBurney M, Eqqersdorfer M, Weber P (2012) Dietary surveys indicate vitamin intakes below recommendations are common in representative western countries. Br J Nutr 108:692–698

    Article  CAS  Google Scholar 

  9. Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, Fuleihan GE, Josse RG, Lips P, Morales-Torres J (2009) Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int 20:1807–1820

    Article  CAS  Google Scholar 

  10. Zhang W, Stoecklin E, Eqqersdorfer M (2013) A glimpse of vitamin D status in mainland China. Nutrition 29:953–957

    Article  PubMed  Google Scholar 

  11. Ning Z, Song S, Miao L, Zhang P, Wang X, Liu J, Hu Y Xu Y, Zhao Tm Liang Y, Wang Q, Liu L, Zhang J, Hu L, Huo M, Zhou Q (2016) High prevalence of vitamin D deficiency in urban health checkup population. Clin Nutr 35:859–863

    Article  PubMed  Google Scholar 

  12. Du X, Fraser DR, Greenfield H, Ge K, Trube A, Wang Y (2001) Vitamin D deficiency and associated factors in adolescent girls in Beijing. Am J Clin Nutr 74:494–500

    Article  CAS  PubMed  Google Scholar 

  13. Song S, Zhou L, Si S, Liu J, Zhou J, Feng K, Wu J, Zhang W, Harvey H (2013) The high prevalence of vitamin D deficiency and its related maternal factors in pregnant women in Beijing. PLoS One 8:e85081

    Article  PubMed  Google Scholar 

  14. Lu HK, Zhang Z, Ke YH, He JW, Fu WZ, Zhang CQ, Zhang ZL (2012) High prevalence of vitamin D insufficiency in China: relationship with the levels of parathyroid hormone and markers of bone turnover. PLoS One 7:e47264

    Article  CAS  PubMed  Google Scholar 

  15. Yan L, Prentice A, Zhang H, Wang X, Stirling DM, Golden MM (2000) Vitamin D status and parathyroid hormone concentrations in Chinese women and men from north-east of the People’s Republic of China. Eur J Clin Nutr 54:68–72

    Article  CAS  PubMed  Google Scholar 

  16. Ren C, Qiu M, Wang D, Luo H, Zhang D, Wang Z, Wang F, Li Y, Zhou Z, Xu R (2012) Prognostic effects of 25-hydroxyvitamin D levels in gastric cancer. J Transl Med 10:16

    Article  CAS  PubMed  Google Scholar 

  17. IOM (Institute of Medicine) (2011) Dietary reference intakes for calcium and vitamin D. The National Academies Press, Washington, DC

    Google Scholar 

  18. Prentice A (2008) Vitamin D deficiency: a global perspective. Nutr Rev 66(Suppl 2):153–164

    Article  Google Scholar 

  19. 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 146:1051–1061

    Article  CAS  PubMed  Google Scholar 

  20. Choi HS, Oh HJ, Choi H, Choi WH Kim JG, Kim KM, Kim KJ, Rhee Y, Lim S (2011) Vitamin D insufficiency in Korea-a greater threat to younger generation: the Korea national health and nutrition examination survey (KNHANES) 2008. J Clin Endocrinol Metab 96:643–651

    Article  CAS  Google Scholar 

  21. MacLaughlin J, Holick MF (1985) Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest 76:1536–1538

    Article  CAS  PubMed  Google Scholar 

  22. Ginde AA, Liu MC, Camargo CA (2009) Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004. Arch Intern Med 169:626–632

    Article  CAS  PubMed  Google Scholar 

  23. Nakamura K, Kitamura K, Takachi R, Saito T, Kobayashi R, Oshiki R, Watanabe Y, Tsugane S, Sasaki A, Yamazaki O (2015) Impact of demographic, environmental, and lifestyle factors on vitamin D sufficiency in 9084 Japanese adults. Bone 74:10–17

    Article  CAS  Google Scholar 

  24. Chen J, 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 16:3

    Article  PubMed  Google Scholar 

  25. Nurbazlin M, Chee WS, Rokiah P, Tan AT, Chew YY, Nusaibah AR, Chan SP (2013) Effects of sun exposure on 25 (OH) vitamin D concentration in urban and rural women in Malaysia. Asia Pac J Clin Nutr 22:391–399

    CAS  Google Scholar 

  26. Heere C, Skeaff CM, Waqatakirewa L, Vatucawaqa P, Khan AN, Green TJ (2010) Serum 25-hydeoxyvitamin D concentration of indigenous-Fijian and Fijian-Indian women. Asia Pac J Clin Nutr 19:43–48

    CAS  Google Scholar 

  27. Gao Q, Wang F, Hu L, Yu J, Liu R, Wang Y, Liu Y (2017) Changes in time spent outdoors during the daytime in rural populations in four geographically distinct regions in China: a retrospective study. Photochem Photobiol 93:619–625

    Article  CAS  Google Scholar 

  28. Liu H, Fang H, Zhao Z (2013) Urban-rural disparities of child health and nutritional status in China from 1989 to 2006. Econ Hum Biol 11:294–309

    Article  Google Scholar 

  29. Li L, Yin X, Yao C, Zhu X, Wu X (2012) Vitamin D, parathyroid hormone and their associations with hypertension in a Chinese population. PLoS One 7:e43344

    Article  CAS  PubMed  Google Scholar 

  30. van Schoor N, Lips P (2017) Global overview of vitamin D status. Endocrinol Metab Clin N Am 46:845–870

    Article  Google Scholar 

  31. Pludowski P, Grant WB, Bhattoa HP, Bayer M, Povoroznyuk V, Rudenka E, Ramanau H, Varbiro S, Rudenka A, Karczmarewicz E, Lorenc R, Czech-Kowalska JC, Konstantynowicz J (2014) Vitamin D status in central Europe. Int J Endocrinol 2014:589587

    Article  PubMed  Google Scholar 

  32. 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 14:159

    Article  PubMed  Google Scholar 

  33. Omrani GR, Masoompour SM, Sadegholvaad A, Larijani B (2006) Effects of menopause and renal function on vitamin D status in Iranian women. East Mediterr Health J 12:188–195

    CAS  PubMed  Google Scholar 

  34. Goswami R, Gupta N, Goswami D, Marwaha RK, Tandon N, Kochupillai N (2000) Prevalence and significance of low 25-hydroxyvitamin D concentrations in healthy subjects in Delhi. Am J Clin Nutr 72:472–475

    Article  CAS  PubMed  Google Scholar 

  35. Liu J, Zhang W (2015) The influence of the environment and clothing on human exposure to ultraviolet light. PLoS One 10:e0124758

    Article  PubMed  Google Scholar 

  36. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanldy DA, Heaney RP, Murad MH, Weaver CM (2012) Guidelines for preventing and treating vitamin D deficiency and insufficiency revisited. J Clin Endocrinol Metab 97:1153–1158

    Article  CAS  PubMed  Google Scholar 

  37. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930

    Article  CAS  PubMed  Google Scholar 

  38. Alshahrani F, Aljohani N (2013) Vitamin D: deficiency, sufficiency and toxicity. Nutrients 5:3605–3616

    Article  PubMed  Google Scholar 

  39. Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Mayne ST, Rosen CJ, Shapses SA (2011) 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 96:53–58

    Article  CAS  PubMed  Google Scholar 

  40. Melamed ML, Michos ED, Post W, Astor B (2008) 25-Hydroxyvitamin D levels and the risk of mortality in the general population. Arch Intern Med 168:1629–1637

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We thank Ms. Lili Fan for advice regarding statistical analysis. This work was supported by the National Natural Science Foundation of China (Grant No. 81330064) and the Tianjin Science and Technology Committee Project Foundation (Grant No. 14ZCZDSY00022).

Author information

Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, 300052, China

    Fang Fang, Hongyan Wei, Kunling Wang, Li Ding, Tong Liu & Mei Zhu

  2. Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China

    Long Tan & Wanqi Zhang

  3. Department of Endocrinology and Metabolism and Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, 110001, China

    Zhongyan Shan

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  1. Fang Fang
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Correspondence to Mei Zhu.

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The study was approved by the ethics committee of the First Hospital of China Medical University and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Written informed consent was obtained from all participants.

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Fang, F., Wei, H., Wang, K. et al. High prevalence of vitamin D deficiency and influencing factors among urban and rural residents in Tianjin, China. Arch Osteoporos 13, 64 (2018). https://doi.org/10.1007/s11657-018-0479-8

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