Proposal and Validation of a Quick Question to Rate the Influence of Sun Exposure in Geriatric Epidemiological Studies on Vitamin D

2012 ◽  
Vol 82 (6) ◽  
pp. 412-416 ◽  
Author(s):  
Cédric Annweiler ◽  
Anne-Marie Schott ◽  
Olivier Beauchet

Background: Vitamin D is synthesized in the skin under the action of solar ultraviolet-B radiation. The objective of this study was to determine whether a simple question exploring sun exposure (“When weather is nice, do you stay more than 15 minutes exposed to the sun (face and hands uncovered) between 11am and 3pm?”) could be associated with serum 25-hydroxyvitamin D status among 751 older community-dwelling women (mean age, 80.2 ± 3.5 years). Methods: Two groups were distinguished based on the binary “Yes” versus “No” answer. Hypovitaminosis D was defined as serum 25-hydroxyvitamin D < 30 ng/mL. Results: Fewer women with hypovitaminosis D answered “Yes” to the question on sun exposure (p = 0.042). Answering “Yes” was inversely associated with hypovitaminosis D (OR = 0.56, p = 0.049) after adjustment for demographic characteristics and exogenous sources of vitamin D, with a positive predictive value of 88 %. Conclusion: This simple question may reflect the sun’s influence on vitamin D status and identify older community-dwellers with hypovitaminosis D.

2013 ◽  
Vol 83 (4) ◽  
pp. 254-258 ◽  
Author(s):  
Gaëlle Chevallereau ◽  
Xavier Gleyses ◽  
Laurène Roussel ◽  
Sarah Hamdan ◽  
Olivier Beauchet ◽  
...  

Background: Diet is a major exogenous source of vitamin D. The objective of this analysis was to determine whether the yes/no answer to a simple question exploring diet (“Do you eat fatty fish at least once a week and/or eggs several times per week?”) could be associated with serum 25-hydroxy-vitamin D status among 261 older in- and outpatients (mean ± standard deviation, 83.5 ± 8.1 years). Methods: Two groups were distinguished based on the binary yes/no answer. Hypovitaminosis D was defined as serum 25-hydroxyvitamin D ≤ 75 nmol/L. Results: More participants with hypovitaminosis D answered “No” to the question on diet compared to their counterparts (p = 0.002). Answering “No” was associated with hypovitaminosis D (OR = 3.22, p = 0.001) after adjustment for potential confounders, with a positive predictive value = 79 %. Conclusion: A simple dietary question may identify older patients with hypovitaminosis D who should receive vitamin D supplements.


Author(s):  
Ênio Damaso ◽  
Francisco Paula ◽  
Silvio Franceschini ◽  
Carolina Vieira ◽  
Rui Ferriani ◽  
...  

Objectives To assess the prevalence of hypovitaminosis D, altered arterial blood pressure, and serum levels of glucose and lipids in community-dwelling women in the city of Ribeirão Preto, in the southeast of Brazil. Methods This was a cross-sectional study of women aged 40–70 years old. Calcium intake and level of sun exposure were assessed by means of a questionnaire. A blood sample was used to determine glucose, lipid profile and 25-hydroxyvitamin D (25[OH]D) concentration. Results Ninety-one women were enrolled (age = 54.2 ± 7.1 years). The mean serum 25(OH)D concentration was 25.7 ± 8.9 ng/mL. A total of 24 (26.4%) women had 25(OH)D levels < 20 ng/mL. Seventy women (76.9%) had 25(OH)D levels < 30 ng/mL. Seventy-five women (90.4%) had inadequate calcium intake, and 61 women (67%) had appropriate sun exposure, 49 of whom (80.3%) had serum 25(OH)D levels < 30 ng/mL. Conclusion This study indicates that even in community-dwelling women, living in a city with high sun exposure, serum levels of 25(OH)D > 30 ng/ml are hardly reached. Thus, it is probable that other intrinsic factors besides sun exposure may regulate the levels of vitamin D.


Author(s):  
Michael Thompson ◽  
Dawn Aitken ◽  
Saliu Balogun ◽  
Flavia Cicuttini ◽  
Graeme Jones

Abstract Introduction Vitamin D deficiency is a common, modifiable determinant of musculoskeletal health. There are limited data that examine the longitudinal change in population 25-hydroxyvitamin D (25(OH)D) and none that evaluate the long-term skeletal outcomes of longitudinal vitamin D status. Methods Prospective cohort analysis of community-dwelling adults aged 50-80 years who had 25(OH)D assessed by radioimmunoassay and BMD by DXA at baseline (n=1096), 2.5 (n=870) and 10 (n=565) years. Sun exposure was quantified by questionnaire and supplement use at clinic review. 25(OH)D &lt;50nmol/L was considered deficient. Participants were provided with their 25(OH)D results. Results Over 10 years 25(OH)D increased (52.2 ± 17.0 to 63.5 ± 23.6 nmol/L, p&lt;0.001). Participants with baseline deficiency had larger 25(OH)D increases than baseline sufficient participants (19.2 ± 25.3 vs 1.6 ± 23.3 nmol/L, p&lt;0.001). Longitudinal change in 25(OH)D was associated with baseline summer (β=1.46, p&lt;0.001) and winter (β=1.29, p=0.003) sun exposure, change in summer (β=1.27, p=0.002) and winter (β=1.47, p&lt;0.001) sun exposure and vitamin D supplement use (β=25.0 – 33.0, p&lt;0.001). Persistent vitamin D sufficiency was associated with less BMD loss at the femoral neck (β=0.020, p=0.027), lumbar spine (β=0.033, p=0.003) and total hip (β=0.023, p=0.021) compared to persistent vitamin D deficiency. Achieving vitamin D sufficiency was associated with less BMD loss at the lumbar spine (β=0.045, p&lt;0.001) compared to persistent vitamin D deficiency. Conclusions Population 25(OH)D concentration increased due to a combination of increased sun exposure and supplement use. Maintaining or achieving vitamin D sufficiency was associated with less BMD loss over 10 years.


2020 ◽  
Vol 90 (3-4) ◽  
pp. 195-199 ◽  
Author(s):  
Gaelle Chevallereau ◽  
Mathilde Legeay ◽  
Guillaume T. Duval ◽  
Spyridon N. Karras ◽  
Bruno Fantino ◽  
...  

Abstract. Despite the high prevalence of hypovitaminosis D in older adults, universal vitamin D supplementation is not recommended due to potential risk of intoxication. Our aim here was to determine the clinical profiles of older community-dwellers with hypovitaminosis D. The perspective is to build novel strategies to screen for and supplement those with hypovitaminosis D. A classification tree (CHAID analysis) was performed on multiple datasets standardizedly collected from 1991 older French community-dwelling volunteers ≥ 65 years in 2009–2012. Hypovitaminosis D was defined as serum 25-hydroxyvitamin D ≤ 50 nmol/L. CHAID analysis retained 5 clinical profiles of older community-dwellers with different risks of hypovitaminosis D up to 87.3%, based on various combinations of the following characteristics: polymorbidity, obesity, sadness and gait disorders. For instance, the probability of hypovitaminosis D was 1.42-fold higher [95CI: 1.27–1.59] for those with polymorbidity and gait disorders compared to those with no polymorbidity, no obesity and no sadness. In conclusion, these easily-recordable measures may be used in clinical routine to identify older community-dwellers for whom vitamin D supplementation should be initiated.


Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 573
Author(s):  
Naoko Tsugawa ◽  
Mayu Nishino ◽  
Akiko Kuwabara ◽  
Honami Ogasawara ◽  
Maya Kamao ◽  
...  

Background: Breast milk is considered the optimal source of nutrition during infancy. Although the vitamin D concentration in human breast milk is generally considered poor for infants, vitamin D in breast milk is an important source for exclusively breastfed infants. Increases in vitamin D insufficiency and deficiency in lactating mothers may reduce vitamin D concentrations in breast milk. This study aimed to compare vitamin D and 25-hydroxyvitamin D (25OHD) concentrations in breast milk collected in 1989 and 2016–2017 and simultaneously analyze them with liquid chromatography-tandem mass spectrometry (LC-MS/MS); the association between the lifestyle of recent lactating mothers (2016–2017) and vitamin D status in human breast milk was also evaluated. Method: Lactating mothers were recruited from three regions of Japan in 1989 (n = 72) and 2016–2017 (n = 90), and milk from 3–4 months was collected in summer and winter. The samples were strictly sealed and stored at −80℃ until measurement. Breast milk vitamin D and 25OHD concentrations were analyzed by LC-MS/MS. Vitamin D intake, sun exposure, and sunscreen use of the lactating mothers in 2016–2017 were assessed. Results: Both vitamin D and 25OHD concentrations in breast milk were higher in the summer regardless of the survey year. Significantly lower vitamin D and 25OHD concentrations were observed in 2016–2017 compared with 1989 in summer, but no survey year difference was observed in winter. The stepwise multiple regression analyses identified season, daily outdoor activity, and suntan in the last 12 months as independent factors associated with vitamin D3 concentrations. Conclusion: The results suggest that low vitamin D status in recent lactating mothers may have decreased vitamin D and 25OHD concentrations in breast milk compared with the 1980s. These results are helpful for developing public health strategies to improve vitamin D status in lactating mothers and infants.


2010 ◽  
Vol 95 (6) ◽  
pp. 2637-2645 ◽  
Author(s):  
Håkan Melhus ◽  
Greta Snellman ◽  
Rolf Gedeborg ◽  
Liisa Byberg ◽  
Lars Berglund ◽  
...  

Abstract Context: Blood levels of 25-hydroxyvitamin D [25(OH)D] is the generally accepted indicator of vitamin D status, but no universal reference level has been reached. Objective: The objective of the study was to determine the threshold at which low plasma 25(OH)D levels are associated with fractures in elderly men and clarify the importance of low levels on total fracture burden. Design and Participants: In the Uppsala Longitudinal Study of Adult Men, a population-based cohort (mean age, 71 yr, n = 1194), we examined the relationship between 25(OH)D and risk for fracture. Plasma 25(OH)D levels were measured with high-pressure liquid chromatography-mass spectrometry. Setting: The study was conducted in the municipality of Uppsala in Sweden, a country with a high fracture incidence. Main Outcome Measure: Time to fracture was measured. Results: During follow-up (median 11 yr), 309 of the participants (26%) sustained a fracture. 25(OH)D levels below 40 nmol/liter, which corresponded to the fifth percentile of 25(OH)D, were associated with a modestly increased risk for fracture, multivariable-adjusted hazard ratio 1.65 (95% confidence interval 1.09–2.49). No risk difference was detected above this level. Approximately 3% of the fractures were attributable to low 25(OH)D levels in this population. Conclusions: Vitamin D insufficiency is not a major cause of fractures in community-dwelling elderly men in Sweden. Despite the fact that cutaneous synthesis of previtamin D during the winter season is undetectable at this northern latitude of 60°, only one in 20 had 25(OH)D levels below 40 nmol/liter, the threshold at which the risk for fracture started to increase. Genetic adaptations to limited UV light may be an explanation for our findings.


Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3082
Author(s):  
Spyridon N. Karras ◽  
Erdinç Dursun ◽  
Merve Alaylıoğlu ◽  
Duygu Gezen-Ak ◽  
Cedric Annweiler ◽  
...  

Recent results indicate that dysregulation of vitamin D-binding protein (VDBP) could be involved in the development of hypovitaminosis D, and it comprises a risk factor for adverse fetal, maternal and neonatal outcomes. Until recently, there was a paucity of results regarding the effect of maternal and neonatal VDBP polymorphisms on vitamin D status during pregnancy in the Mediterranean region, with a high prevalence of hypovitaminosis D. We aimed to evaluate the combined effect of maternal and neonatal VDBP polymorphisms and different maternal and neonatal 25-hydroxyvitamin D (25(OH)D) cut-offs on maternal and neonatal vitamin D profile. Blood samples were obtained from a cohort of 66 mother–child pairs at birth. Our results revealed that: (i) Maternal VDBP polymorphisms do not affect neonatal vitamin D status at birth, in any given internationally adopted maternal or neonatal cut-off for 25(OH)D concentrations; (ii) neonatal VDBP polymorphisms are not implicated in the regulation of neonatal vitamin D status at birth; (iii) comparing the distributions of maternal VDBP polymorphisms and maternal 25(OH)D concentrations, with cut-offs at birth, revealed that mothers with a CC genotype for rs2298850 and a CC genotype for rs4588 tended to demonstrate higher 25(OH)D (≥75 nmol/L) during delivery (p = 0.05 and p = 0.04, respectively), after adjustments for biofactors that affect vitamin D equilibrium, including UVB, BMI and weeks of gestation. In conclusion, this study from Southern Europe indicates that maternal and neonatal VDBP polymorphisms do not affect neonatal vitamin D status at birth, whereas mothers with CC genotype for rs2298850 and CC genotype for rs4588 demonstrate higher 25(OH)D concentrations. Future larger studies are required to establish a causative effect of these specific polymorphisms in the attainment of an adequate (≥75 nmol/L) maternal vitamin D status during pregnancy.


2011 ◽  
Vol 106 (9) ◽  
pp. 1383-1389 ◽  
Author(s):  
R. K. Marwaha ◽  
N. Tandon ◽  
S. Chopra ◽  
N. Agarwal ◽  
M. K. Garg ◽  
...  

The present cross-sectional study was conducted to determine the vitamin D status of pregnant Indian women and their breast-fed infants. Subjects were recruited from the Department of Obstetrics, Armed Forces Clinic and Army Hospital (Research and Referral), Delhi. A total of 541 apparently healthy women with uncomplicated, single, intra-uterine gestation reporting in any trimester were consecutively recruited. Of these 541 women, 299 (first trimester, ninety-seven; second trimester, 125; third trimester, seventy-seven) were recruited in summer (April–October) and 242 (first trimester, fifty-nine, second trimester, ninety-three; third trimester, ninety) were recruited in winter (November–March) to study seasonal variations in vitamin D status. Clinical, dietary, biochemical and hormonal evaluations for the Ca–vitamin D–parathormone axis were performed. A subset of 342 mother–infant pairs was re-evaluated 6 weeks postpartum. Mean serum 25-hydroxyvitamin D (25(OH)D) of pregnant women was 23·2 (sd 12·2) nmol/l. Hypovitaminosis D (25(OH)D < 50 nmol/l) was observed in 96·3 % of the subjects. Serum 25(OH)D levels were significantly lower in winter in the second and third trimesters, while serum intact parathormone (iPTH) and alkaline phosphatase levels were significantly higher in winter in all three trimesters. A significant negative correlation was found between serum 25(OH)D and iPTH in mothers (r − 0·367, P = 0·0001) and infants (r − 0·56, P = 0·0001). A strong positive correlation was observed between 25(OH)D levels of mother–infant pairs (r 0·779, P = 0·0001). A high prevalence of hypovitaminosis D was observed in pregnancy, lactation and infancy with no significant inter-trimester differences in serum 25(OH)D levels.


Author(s):  
Catarina Magalhães Porto ◽  
Natalia Santos Barbosa da Silva ◽  
Cecília Magalhães Porto Lira ◽  
Rayana Porpino Magalhães ◽  
José Luiz Oliveira Magalhães ◽  
...  

Background: One of the risk factors for suicide includes the presence of depressive disorder and symptoms, which may be related to the reduction of 25-hydroxyvitamin D serum levels. In this scenario, evidence shows vitamin D deficiency as an important aspect, directly related to depressive disorder chronicity. Objective: To assess the association between Vitamin D serum levels and the intensity of depressive symptoms and suicidal behavior in a clinical sample of depressed patients. Methods: A cross-sectional study with 146 patients aged between 18 and 59, seen in two psychiatry ambulatories. Data collection involved measurement of serum 25-hydroxyvitamin D levels and assessment of the intensity of depressive symptoms and suicide risk. Results: In the sample, 35% presented low Vitamin D serum levels and, in these individuals, the incidence of family history of Depressive Disorder (95.2%) and chronicity of severe depressive symptoms (47.8%) was higher. As to suicidal behavior, both groups presented high active suicide risk, with higher rates in the group with hypovitaminosis D. Only suicidal ideation was linked to lower Vitamin D levels (67.4% p= 0,005). Conclusion: In this study, hypovitaminosis D was associated with negative mental health outcomes, such as more severe chronicity of depressive symptoms and suicidal behavior, characterized by active suicidal ideation.


1999 ◽  
Vol 81 (2) ◽  
pp. 133-137 ◽  
Author(s):  
Elisabetta Romagnoli ◽  
Patrizia Caravella ◽  
Liliana Scarnecchia ◽  
Paolo Martinez ◽  
Salvatore Minisola

The present study aimed to investigate the prevalence and seasonal variation of hypovitaminosis D (defined as serum 25-hydroxyvitamin D level below 30 nmol/l) among healthy subjects and hospitalized patients living in central Italy. We studied 297 subjects, 131 in February 1997 and 166 in July 1997, subdivided into four groups: (a) young healthy blood donors; (b) healthy postmenopausal women; (c) inpatients with various medical diseases and (d) inpatients engaged in long-term rehabilitation programmes because of various neurological disorders. In all subjects and patients serum levels of 25-hydroxyvitamin D were measured by radioimmunoassay. We found a significant seasonal variation (P< 0·0001) of serum 25-hydroxyvitamin D levels, mean values being higher in summer in all groups, except in patients with a longer hospitalization time (group (d)). In each group, a significantly higher prevalence of hypovitaminosis D was found in winter compared with summer time (P< 0·001), being unexpectedly high in postmenopausal women (winter 32 % and summer 4·5 %); furthermore, in both seasons, inpatients were characterized by the highest incidences of hypovitaminosis, particularly those in group (d) (winter 82·3 % and summer 57·8 %). The results of the present study emphasize the importance of 25-hydroxyvitamin D measurement, and the need to increase vitamin D intake in Italy; foodstuff fortification and supplement use must be considered in order to prevent negative effects of vitamin D deficiency on skeletal integrity.


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