The Prevalence of Hypovitaminosis D and Its Associated Risk Factors Among Women of Reproductive Age in Saudi Arabia: A Systematic Review and Meta-Analysis

Vitamin D deficiency is currently a worldwide epidemic. Middle Eastern countries, including Saudi Arabia, have high vitamin D deficiency prevalence, most prominently among women, despite their plentiful year-round sunshine. Previous research investigating vitamin D status among Saudi women of reproductive age (15-49 years) is scarce, and no study has used a nationally representative sample, so this review quantified overall hypovitaminosis D prevalence among women in Saudi Arabia and explored the associated risk factors. The Web of Science, Scopus, and Medline databases were searched for prior studies in Saudi Arabia exploring vitamin D status among women of reproductive age, published between January 1, 2000 and May 25, 2017. Data were extracted from the identified studies, and a random effects model meta-analysis established the overall hypovitaminosis D prevalence. The initial search yielded 223 possibly relevant articles; 13 were confirmed as eligible, with samples totaling 2877 women aged between 15 and 49 years. Meta-analysis revealed a mean serum 25-hydroxyvitamin D, 25(OH)D, level of 13.1 ng/mL (95% confidence interval [CI]: 11.6-14.6) and an overall prevalence of hypovitaminosis D, defined as 25(OH)D < 30 ng/mL, of 77.4% (95% CI: 63.2-87.3), mostly due to insufficient sunlight exposure and low dietary vitamin D intake. There is therefore a need for a national strategy to raise vitamin D levels among women in Saudi Arabia by advising them on natural vitamin D sources, and recommending the timing and duration of sun exposure, while also defining a national approach to vitamin D fortification and supplementation.

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Vitamin D Deficiency and Associated Risk Factors in Women from Riyadh, Saudi Arabia

Scientific Reports ◽

10.1038/s41598-019-56830-z ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Nora A. AlFaris ◽

Nora M. AlKehayez ◽

Fatema I. AlMushawah ◽

AbdulRhman N. AlNaeem ◽

Nadia D. AlAmri ◽

...

Keyword(s):

Risk Factors ◽

Vitamin D ◽

Saudi Arabia ◽

Vitamin D Deficiency ◽

Public Awareness ◽

Public Health Problem ◽

Hypovitaminosis D ◽

Cross Sectional Study ◽

Cross Sectional ◽

Associated Risk Factors

AbstractVitamin D deficiency is an epidemic public health problem worldwide. It is common in the Middle East and is more severe in women. This cross-sectional study was conducted to assess vitamin D deficiency and associated risk factors in women living in Riyadh, Saudi Arabia. Serum 25-hydroxyvitamin D (25(OH)D) was measured in 166 women aged 30–65 years. Socio-demographic, lifestyle and health status characteristics, as well as intake of selected dietary supplements, were collected. Weight and height were measured. Vitamin D deficiency (25(OH)D < 20 ng/mL) was reported in 60.2% of participants. Mean of serum 25(OH)D was 20.7 ng/mL. Older age and taking the supplements of vitamin D, multi-vitamins or calcium were identified as factors that associated with a lower risk of hypovitaminosis D. A national strategy is needed to control a hypovitaminosis D crisis in Saudi Arabia. This could be accomplished by raising public awareness regarding vitamin D, regulating and enhancing vitamin D fortification and supplementation and screening vitamin D status among women at high risk.

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Vitamin D Status and Its Associated Risk Factors among Adults in the Southwest Region of Cameroon

Journal of Nutrition and Metabolism ◽

10.1155/2018/4742574 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Delphine A. Tangoh ◽

Tobias O. Apinjoh ◽

Yasir Mahmood ◽

Robert V. Nyingchu ◽

Beatrice A. Tangunyi ◽

...

Keyword(s):

Risk Factors ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Hypovitaminosis D ◽

Vitamin D Status ◽

West Region ◽

South West ◽

Study Population ◽

Associated Risk Factors ◽

South West Region

Background. Vitamin D has been shown to exert its actions on the musculoskeletal, gastrointestinal, prostate, renal, endocrine, immune, and cardiovascular systems. Current reported data of hypovitaminosis D reveals a global pandemic, with an estimated one billion people worldwide presenting with hypovitaminosis D. Objective. This study aimed at investigating the vitamin D status and its associated risk factors in Cameroonians from the South West Region. Method. The study was a community- and hospital-based prospective longitudinal study. It was carried out during the dry and rainy seasons between the months of July and December 2015 in the South West Region of Cameroon involving 372 participants aged 35 years and above. After obtaining informed consent, a structured questionnaire was used to capture demographic data and risk factors of vitamin D deficiency. Blood samples were collected from the volunteer participants in the peak months of the rainy season and dry season, and the serum used to analyse for vitamin D by ELISA and calcium by spectrophotometry. 25(OH)D levels ≥75 nmol/L (≥30 ng/mL) were considered sufficient while levels <75 nmol/L were considered as hypovitaminosis D (insufficiency/deficiency). Results. Hypovitaminosis D (deficiency/insufficiency) was prevalent in 25.8% (96) of the study population, with only 3.2% (12) deficiency and 22.6% (84) insufficiency. There was a significant inverse relationship r=−0.119,p=0.02 between age and 25(OH)D levels; however, this relationship was not significant when controlled for gender, number of hours spent outdoors, and percentage of body covered. Gender, ethnic origin, percentage of body covered, time spent outdoors, and season did not influence serum vitamin D levels. Conclusion. Results of this study suggest that the prevalence of hypovitaminosis D is relatively low in this study population and only age is a risk factor of vitamin D deficiency.

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Seroprevalence of Toxoplasma gondii and its associated risk factors among women of reproductive age in Saudi Arabia: a systematic review and meta-analysis

International Journal of Women s Health ◽

10.2147/ijwh.s173640 ◽

2018 ◽

Vol Volume 10 ◽

pp. 537-544 ◽

Cited By ~ 1

Author(s):

Riyadh Alzaheb

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Saudi Arabia ◽

Toxoplasma Gondii ◽

Meta Analysis ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Associated Risk Factors

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Assessment of risk factors associated with vitamin D status among children of an urban and a rural areas of Bangladesh

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v46i2.49024 ◽

2020 ◽

Vol 46 (2) ◽

pp. 134-141

Author(s):

Anamika Saha ◽

Md Salim Shakur ◽

Runa Laila ◽

Salomee Shakur ◽

Md Sohel Shomik ◽

...

Keyword(s):

Risk Factors ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Hypovitaminosis D ◽

Urban Children ◽

Outpatient Department ◽

P Value ◽

Rural Children ◽

Vitamin D Status ◽

Factors Associated

Background: Vitamin D deficiency is one of the most common micronutrient deficiency in children worldwide, even in Bangladesh. However, to date, the prevalence of vitamin D deficiency among children of different region of Bangladesh is less reported. Objective: This study was conducted to assess vitamin D status of urban and rural Bangladeshi children including the risk factors associated with vitamin D deficiency are also evaluated. Methods: A multi-centre (urban and rural based), cross sectional study was done from July 2016 to June 2017, using serum 25(OH) vitamin D3 as a marker of nutritional vitamin D status. Urban and rural children were taken from Paediatric Outpatient Department, United Hospital Limited. Dhaka and Medical Outpatient Department, Upazila Health Complex, Ghatail, Tangail respectively. Children of 1-10 years age attending OPD with mild undernutrition (<–1 SD z score) and/or clinical features suggestive of vitamin D deficiency were included in the study. Results: A total 150 children were studied with 102 (68.0%) urban and 48 (32.0%) rural children. Hypovitaminosis D (25-OHD <30ng/ml) was found in 75.0% of children. Hypovitaminosis D was found significantly more in urban children (81.0%) compared to rural (62.0%) children (OR=0.382, 95% CI: 0.177-0.822, p value <0.05). Inadequate exposure to sunlight was significantly associated with hypovitaminosis D compared to adequate sun exposure and it was about 2.5 times higher (OR=2.475, 95% CI: 1.139-5.380, p value <0.05). No significant associations of vitamin D deficiency were detected with skin color of children, covering clothes of mother, exclusive breast feeding, limb pain and anthropometric status. Children of higher educated mother (above Secondary School Certificate) (OR=0.412, 95% CI: 0.189-0.900) were more associated with vitamin D deficiency. Conclusion: Vitamin D deficiency (VDD) is prevalent among Bangladeshi children, urban children being more vulnerable to VDD. Adoption of a screening programme for children of all age group and implementation of preventive strategies for VDD through public health policies are strongly recommended. Bangladesh Med Res Counc Bull 2020; 46(2): 134-141

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Hypovitaminosis D in Healthy Toddlers and Preschool Children from Western Saudi Arabia

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000223 ◽

2015 ◽

Vol 85 (1-2) ◽

pp. 50-60 ◽

Cited By ~ 7

Author(s):

Osama A. Kensarah ◽

Abdelelah S. Jazar ◽

Firas S. Azzeh

Keyword(s):

Vitamin D ◽

Saudi Arabia ◽

Preschool Children ◽

Vitamin D Deficiency ◽

Physical Inactivity ◽

Hypovitaminosis D ◽

Formula Feeding ◽

Health Concern ◽

Vitamin D Status ◽

Vitamin D Intake

Abstract. Background: Vitamin D deficiency is common in Saudi Arabia. No sufficient data are available on the vitamin D status of preschool children. Aims: To investigate the vitamin D status among toddlers and preschool children and to evaluate the factors associated with hypovitaminosis D in Western Saudi Arabia. Methods: A cross-sectional study was conducted on 503 preschool children in Makkah. The children were divided into two age categories: 1 - 3 years (toddlers) and 3 - 6 years (preschool). Sociodemographic factors, life-style factors, eating habits, body mass index (BMI), 25-(OH)-vitamin D3, parathyroid hormone, calcium, phosphorous, and alkaline phosphatase concentrations were determined. Results: Sixty-three % of children had a vitamin D deficiency. Vitamin D in toddlers was significantly higher than in preschool children. Vitamin D levels were negatively correlated with BMI (r = - 0.419, P < 0.001), and duration of breast feeding (r = - 0.270, P = 0.027), but a significant positive correlation with vitamin D intake (r = 0.335, P = 0.021), calcium intake (r = 0.25, P = 0.029), duration of formula feeding (r = 0.354, P = 0.019), and outdoor physical activity (r = 0.381, P = 0.011) was found. Multivariable predictors of hypovitaminosis D were preschool age (OR = 11, [95 % CI: 2.78 - 43.57], P < 0.001), outdoor physical inactivity (OR = 2.44, [95 % CI: 0.93 - 14.12], P < 0.001), obesity (OR = 2.3, [95 % CI: 1.25 - 7.08], P = 0.008), overweight (OR = 2.16, [95 % CI: 1.18 - 6.01], P = 0.039), inadequate vitamin D intake (OR = 1.65, [95 % CI: 1.12 - 2.53], P = 0.012), exclusive formula feeding (OR = 0.53, [95 % CI: 0.41 - 0.72], P < 0.001), and breast and formula feeding (OR = 0.62 [95 % CI: 0.39 - 0.88], P = 0.002). Conclusion: Hypovitaminosis D is a public health concern, especially in preschool children. Possible determinants of low vitamin D status in preschool children in the Makkah region could be related to age, high BMI, inadequate vitamin D intake, exclusive breastfeeding, and outdoor physical inactivity.

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Hypovitaminosis D and risk factors in pediatric epilepsy children

BMC Pediatrics ◽

10.1186/s12887-021-02906-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Napakjira Likasitthananon ◽

Charcrin Nabangchang ◽

Thitiwan Simasathien ◽

Suchavadee Vichutavate ◽

Voraluck Phatarakijnirund ◽

...

Keyword(s):

Risk Factors ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Significant Risk ◽

Serum Vitamin ◽

Hypovitaminosis D ◽

Pediatric Epilepsy ◽

Vitamin D Status ◽

Tropical Zone ◽

Serum Vitamin D

Abstract Background Anti-seizure medication (ASM) treatment is one of the significant risk factors associated with abnormal vitamin D status in epilepsy patients. Multiple studies have shown that adult epilepsy patients can exhibit vitamin D deficiency. However, there are few reports investigating pediatric epilepsy patients. In this study, we aimed to identify risk factors related to hypovitaminosis D in pediatric epilepsy patients in Thailand. Methods A cross-sectional retrospective cohort study was conducted in 138 pediatric epilepsy patients who received anticonvulsants from April 2018 to January 2019. Demographic data, seizure types, puberty status, physical activity, duration, and types of anti-seizure medications were analyzed. Patients with abnormal liver function, abnormal renal function, and who received vitamin D supplements or ketogenic diet containing vitamin D were excluded. Levels of serum vitamin D (25(OH)D) were measured. Results All 138 subjects were enrolled, the age ranged from 1.04 – 19.96 years; (mean = 9.65 ± 5.09), the mean serum 25(OH) D level was 26.56 ± 9.67 ng/ml. The prevalence of vitamin D deficiency was 23.2% and insufficiency was 47.8% respectively. Two risk factors—puberty status (OR 5.43, 95% CI 1.879-15.67) and non-enzyme-inhibiting ASMs therapy (OR 3.58, 95% CI 1.117-11.46)—were significantly associated with hypovitaminosis D, as shown by multivariate analyses. Conclusions Our study reports the high prevalence of hypovitaminosis D in pediatric epilepsy patients in Thailand despite being located in the tropical zone. These findings can guide clinicians to measure vitamin D status in pediatric epilepsy patients particularly when they reach puberty and/or are using non-enzyme-inhibiting ASMs therapy. Early detection of vitamin D status and prompt vitamin D supplementation can prevent fractures and osteoporosis later in life. Trial registration TCTR20210215005 (http://www.clinicaltrials.in.th/).

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Determinants of Vitamin D Status of Women of Reproductive Age in Dhaka, Bangladesh: Insights from Husband–Wife Comparisons

Current Developments in Nutrition ◽

10.1093/cdn/nzz112 ◽

2019 ◽

Vol 3 (11) ◽

Author(s):

Joo-Hyun Jeong ◽

Jill Korsiak ◽

Eszter Papp ◽

Joy Shi ◽

Alison D Gernand ◽

...

Keyword(s):

Vitamin D ◽

Pregnant Women ◽

Vitamin D Deficiency ◽

Reproductive Age ◽

Vitamin D Status ◽

Second Trimester ◽

Women Of Reproductive Age ◽

Hydroxyvitamin D ◽

Vitamin D Supplements ◽

Trial Participants

ABSTRACT Background Vitamin D deficiency is common among women of reproductive age (WRA) in Bangladesh, but the causes remain unclear. Objective To explain the high prevalence of vitamin D deficiency in WRA in Dhaka, Bangladesh, we compared the vitamin D status of pregnant women with that of their husbands and between pregnant and nonpregnant states. Methods This study was an observational substudy of the Maternal Vitamin D for Infant Growth trial conducted in Dhaka, Bangladesh. Women (n = 1300) were enrolled in the second trimester of pregnancy and randomly assigned to 1 of 5 arms consisting of different doses of vitamin D supplements or placebo, with 1 arm continuing supplementation until 6 mo postpartum. A subgroup of trial participants and their husbands with plasma 25-hydroxyvitamin D [25(OH)D] concentration measurements (n = 84), and placebo-group trial participants with serum 25(OH)D measured in the second trimester of pregnancy and 6 mo postpartum (n = 89) were studied using linear mixed-effects regression models. Results The mean ± SD plasma 25(OH)D in pregnant women in the second trimester was 23 ± 11 nmol/L. Adjusting for age and season, 25(OH)D of pregnant women was 30 nmol/L lower (95% CI: −36, −25 nmol/L) than that of men. Only 9% of total variance in 25(OH)D was explained by factors shared by spousal pairs. Selected nonshared factors (BMI, time spent outdoors, involvement in an outdoor job, sunscreen use) did not explain the association of sex with 25(OH)D. Adjusting for age, season, and BMI, 25(OH)D was similar during pregnancy and 6 mo postpartum (mean difference: −2.4 nmol/L; 95% CI: −5.3, 0.4 nmol/L). Conclusions In Dhaka, WRA have substantially poorer vitamin D status than men. Variation in 25(OH)D is not greatly influenced by determinants shared by spouses. Measured nonshared characteristics or pregnancy did not account for the gender differential in 25(OH)D. This trial was registered at clinicaltrials.gov as NCT01924013.

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Prevalence and Predictors of Vitamin D Deficiency and Insufficiency among Pregnant Rural Women in Bangladesh

Nutrients ◽

10.3390/nu13020449 ◽

2021 ◽

Vol 13 (2) ◽

pp. 449

Author(s):

Faruk Ahmed ◽

Hossein Khosravi-Boroujeni ◽

Moududur Rahman Khan ◽

Anjan Kumar Roy ◽

Rubhana Raqib

Keyword(s):

Risk Factors ◽

Vitamin D ◽

Pregnant Women ◽

Vitamin D Deficiency ◽

Gestational Age ◽

First Trimester ◽

Vitamin D Insufficiency ◽

Vitamin D Status ◽

Vitamin A Status ◽

Associated Risk Factors

Although adequate vitamin D status during pregnancy is essential for maternal health and to prevent adverse pregnancy outcomes, limited data exist on vitamin D status and associated risk factors in pregnant rural Bangladeshi women. This study determined the prevalence of vitamin D deficiency and insufficiency, and identified associated risk factors, among these women. A total of 515 pregnant women from rural Bangladesh, gestational age ≤ 20 weeks, participated in this cross-sectional study. A separate logistic regression analysis was applied to determine the risk factors of vitamin D deficiency and insufficiency. Overall, 17.3% of the pregnant women had vitamin D deficiency [serum 25(OH)D concentration <30.0 nmol/L], and 47.2% had vitamin D insufficiency [serum 25(OH)D concentration between 30–<50 nmol/L]. The risk of vitamin D insufficiency was significantly higher among nulliparous pregnant women (OR: 2.72; 95% CI: 1.75–4.23), those in their first trimester (OR: 2.68; 95% CI: 1.39–5.19), anaemic women (OR: 1.53; 95% CI: 0.99–2.35; p = 0.056) and women whose husbands are farmers (OR: 2.06; 95% CI: 1.22–3.50). The risk of vitamin deficiency was significantly higher among younger pregnant women (<25 years; OR: 2.12; 95% CI: 1.06–4.21), nulliparous women (OR: 2.65; 95% CI: 1.34–5.25), women in their first trimester (OR: 2.55; 95% CI: 1.12–5.79) and those with sub-optimal vitamin A status (OR: 2.30; 95% CI: 1.28–4.11). In conclusion, hypovitaminosis D is highly prevalent among pregnant rural Bangladeshi women. Parity and gestational age are the common risk factors of vitamin D deficiency and insufficiency. A husband’s occupation and anaemia status might be important predictors of vitamin D insufficiency, while younger age and sub-optimal vitamin A status are risk factors for vitamin D deficiency in this population.

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Vitamin D Status and Patient Outcomes after Knee or Hip Surgery: A Meta-Analysis

Annals of Nutrition and Metabolism ◽

10.1159/000490670 ◽

2018 ◽

Vol 73 (2) ◽

pp. 121-130 ◽

Cited By ~ 1

Author(s):

Hao Zhang ◽

Xin-hong Zhu ◽

Wei Dong ◽

Quan-Ming Wang

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Patient Outcomes ◽

Meta Analysis ◽

Hypovitaminosis D ◽

Hip Surgery ◽

Harris Hip Score ◽

Vitamin D Status ◽

Joint Surgery ◽

Patient Reported

Background: This study evaluates the effect of vitamin D status in patient outcomes after hip or knee joint surgery. Method: Literature search was carried out in electronic databases, and study selection followed predetermined eligibility criteria. Data were extracted from relevant studies and meta-analyses of standardized mean differences between hypovitaminosis D (vitamin D deficiency or insufficiency) and euvitaminosis D in assessment scores of patient-reported outcomes were performed. Results: A total of 12 studies (2,593 patients; age 69.89 years [95% CI 68.07–71.70]; 35.95% [29.43–42.46] males) were included in the meta-analysis. The prevalence of hypovitaminosis D (vitamin D deficiency or insufficiency) was 33.18% [25.10–41.26], but the combined prevalence of deficiency and insufficiency was 46.99 [34.02–59.96]. Hospital stay was 1.09 days [–0.39 to 2.56] longer in the hypovitaminosis D group compared to the euvitaminosis D group. Preoperatively, Harris Hip Score (HHS) and Knee Society Score were significantly lower (p = 0.001 and p = 0.00001, respectively) in the hypovitaminosis D group than in the euvitaminosis D group. Postoperatively, HHS (p = 0.004) score was significantly lower in the hypovitaminosis D group than in the euvitaminosis D group. Conclusion: The prevalence of hypovitaminosis D is high in osteoarthritis patients undergoing knee or hip surgery. Vitamin D deficiency may affect the outcomes of orthopedic joint surgery. However, randomized trial/s will be required to confirm these findings.

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