The Prevalence of Vitamin D Deficiency in Impoverished Communities in Northern Lima, Peru

Author(s):  
Adam Samuel Kramer ◽  
Michaella Thomas ◽  
Andrew Makowski ◽  
David Drozek

Context: Vitamin D deficiency is a global concern. There are many factors that affect the levels of vitamin D including demographics, gender, skin pigmentation, geographic location, and body mass index (BMI). In Lima, Peru, vitamin D levels may be influenced by ethnicity, socioeconomic status, overcrowded conditions, air pollution, and chronic disease status. Objective: The purpose of this cross-sectional study was to measure the prevalence of vitamin D deficiency and insufficiency in a sample of impoverished adults living in northern Lima. It was hypothesized that more than 40% of the study sample would have deficient levels of vitamin D. The Endocrine Society defines deficient levels asbeing < 20 ng/mL of 25(OH)D3, insufficient being 21–29 ng/mL of 25(OH)D3. Methods: In June 2016, a Global Health team from Ohio University Heritage College of Osteopathic Medicine provided medical clinics in impoverished communities in northern Lima. From a random sample of consenting adults, finger stick capillary blood samples were applied to Whatman protein saver cards and subsequently dried.Dried blood samples were punched, extracted, and analyzed by liquid chromatography tandem mass spectrometry. Participants had BMI measured as well. Results: 25(OH)D3 samples were obtained from 144 adults, 116 (80.6%) women, 20 (13.9%) men, 8 (5.6%) unspecified gender, age range of 18–94 with a mean of 39  years. In 66 patients (45.8%), 25(OH)D3 was deficient. In 74 patients (51.4%), 25(OH)D3 was insufficient. In 4 patients (2.8%), 25(OH)D3 was sufficient. For the women, 57 (49.1%) were deficient, 56 (48.3%) insufficient. For the men, 7 (35%) were deficient, 13 (65%) insufficient. Mean BMI was 27.3, with a range of 17.3–43.3; 40.3% were overweight and 23.6% were obese. No relationship between vitamin D levels and gender was identified (p = 0.203). There was no significant association betweenBMI levels and vitamin D levels (p = 0.418). Conclusions: In this sample, nearly one half of those tested had deficient levels of 25(OH)D3, with the vast majority (97%) having less than sufficient levels. This study population also demonstrated an average BMI of 27.3. Further study is needed to clarify the role of vitamin D as a therapeutic and its relationship with BMI.

2020 ◽  
Vol 90 (3-4) ◽  
pp. 346-352
Author(s):  
Vincenzo Pilone ◽  
Salvatore Tramontano ◽  
Carmen Cutolo ◽  
Federica Marchese ◽  
Antonio Maria Pagano ◽  
...  

Abstract. We aim to assess the prevalence of vitamin D deficiency (VDD) in patients scheduled for bariatric surgery (BS), and to identify factors that might be associated with VDD. We conducted a cross-sectional observational study involving all consecutive patients scheduled for BS from 2017 to 2019. The exclusion criteria were missing data for vitamin D levels, intake of vitamin D supplements in the 3 months prior to serum vitamin D determination, and renal insufficiency. A total of 206 patients (mean age and body mass index [BMI] of 34.9 ± 10.7 years, and 44.3 ± 6.99 kg/m2, respectively) met the inclusion criteria and were enrolled for data analysis. VDD (<19.9 ng/mL), severe VDD (<10 ng/mL), and vitamin D insufficiency (20–29.9 ng/mL) were present in 68.8 %, 12.5 %, and 31.2 % of patients, respectively. A significant inverse correlation was found between vitamin D levels and initial BMI, parathyroid hormone, and homeostatic model assessment of insulin resistance (r = −0.280, p < 0.05; r = −0.407, p = 0.038; r = −0.445, p = 0.005), respectively. VDD was significantly more prevalent in patients with higher BMI [−0.413 ± 0.12, CI95 % (−0.659; −0.167), p = 0.006], whereas no significant association between hypertension [−1.005 ± 1.65, CI95 % (−4.338; 2.326), p = 0.001], and diabetes type 2 (T2D) [−0.44 ± 2.20, CI95 % (−4.876; 3.986), p = 0.841] was found. We observed significant association between female sex and levels of vitamin D [6.69 ± 2.31, CI95 % (2.06; 11.33), p = 0.006]. The present study shows that in patients scheduled for BS, VDD deficiency is common and was associated with higher BMI, and female sex.


2020 ◽  
Vol 10 (01) ◽  
pp. e87-e92
Author(s):  
Chandrika Azad ◽  
Vishal Guglani ◽  
Jasbinder Kaur ◽  
Roosy Aulakh ◽  
Sukhvinder Singh ◽  
...  

AbstractVitamin D deficiency is prevalent all over the world, especially in tropical countries. In epileptics, antiepileptic drugs (AED) and associated comorbidities further impact vitamin D status. The aim of this study is to estimate the prevalence of 25(OH) vitamin D deficiency in epileptic children and evaluate probable risk factors. A cross-sectional study of 200 children between 1 and 18 years of age on AED was undertaken in the pediatric neurology clinic of a tertiary care center of Northern India. In all children, serum 25(OH) vitamin D levels, calcium, phosphorus, and alkaline phosphatase were estimated. The deficiency levels of vitamin D were categorized as: deficiency <20 ng/mL, insufficiency 20 to 30 ng/mL, and sufficiency >30 ng/mL. The potential risk factors for hypovitaminosis D, including type of epilepsy, AED regimen (specific medications, polytherapy vs. monotherapy), cerebral palsy, ambulatory status, intellectual disability, body mass index, gender, and vegetarianism were examined. Among the 200 enrolled children (60% boys), 106/200 (53%) were vitamin D deficient. There was no significant relation of vitamin D levels with gender, type of epilepsy, neurological deficit, and type of AED. An inverse relationship of higher phenytoin doses during monotherapy associated with lower vitamin D levels in monotherapy was found, thereby suggesting adverse effect of high doses of phenytoin on vitamin D levels. VDD is common among epileptic children on AED therapy. Vitamin D deficiency is common prevalent among epileptic children on AED therapy, and its detection and treatment correction should be an integral part of epilepsy management.


2020 ◽  
Vol 48 (12) ◽  
pp. 030006052097424
Author(s):  
Enas Al-Zayadneh ◽  
Nedal Awad Alnawaiseh ◽  
Salma Ajarmeh ◽  
Areej Hamed Altarawneh ◽  
Eman M Albataineh ◽  
...  

Objectives To assess serum 25-hydroxycholecalciferol (25-OH vitamin D) levels in Jordanian children with bronchial asthma, and to examine correlations between 25-OH vitamin D levels and asthma severity and control. Methods A cross-sectional study was conducted at the Paediatric Chest Clinic, Al-Karak Governmental Hospital, Southern Jordan, between May 2015 and February 2016. Serum 25-hydroxyvitamin D level was determined in children aged 1–14 years diagnosed with bronchial asthma (6–14 years) or recurrent wheezing episodes (<6 years). Asthma severity was determined based on the Global Initiative for Asthma assessment, the Asthma Control Test, and the Childhood Asthma Control Test. Demographic and clinical characteristics were compared between patients with low and normal 25-OH vitamin D levels, and correlations between asthma severity and 25-OH vitamin D level were assessed. Results Out of 98 included children, 25-OH vitamin D levels were deficient and insufficient in 41 (41.8%) and 34 (34.7%) children, respectively. Only 23 (23.5%) had sufficient 25-OH vitamin D levels. A significant correlation was found between severity of asthma symptoms and 25-OH vitamin D deficiency. Conclusion 25-OH vitamin D deficiency is highly prevalent in Jordanian children with bronchial asthma and correlates significantly with asthma severity.


2012 ◽  
Vol 19 (02) ◽  
pp. 208-213
Author(s):  
MUHAMMAD ASLAM ◽  
ZAHID MASOOD ◽  
Abdul SATTAR ◽  
Maria Qudsia

Objective: To study the Prevalence of Vitamin D deficiency in pregnant women. Study Design: A Cross-sectional analyticalstudy through convenient sampling technique. Setting and duration: At a private Clinic located at East Canal Road Faisalabad, from March2011 to June 2011. Material and method: The study included consecutive 61 pregnant women of reproductive age and non-pregnant womenwere excluded. Blood samples were taken in morning i.e. overnight fasting samples, by venepuncture by disposable syringes sample weretaken and samples were stored at -20 degree centigrade till they were analyzed. Our interest was in age and serum Vitamin D 3 levels. Results:Out of 61 pregnant women results showed that 87.0% pregnant women were having Vitamin D deficiency, 10.0% were having Vitamin Dinsufficiency, 3.0% had Vitamin D sufficiency and none shows Vitamin D intoxication. Vitamin D deficiency was more prevalent in pregnantwomen of younger age group. Furthermore prevalence was higher among the pregnant mothers with high parity. Moreover, 65% women werenot exposed to sunlight properly, 60% women had muscle cramps and bony aches. 90% women never were tested for tested Vitamin D levelsbefore. Conclusions: Prevalence of Vitamin D deficiency is significant in pregnant women. It is also important for its effects on various organsand systems of body as well as on pregnancy and neonate. The different aspects of study led to conclusion to emphasize that Health educationbe imparted to pregnant women and their families in terms of diet, proper sunlight exposure and taking Vitamin D supplements in pregnancy. It isthus recommended to perform Vitamin D levels in every pregnant woman.


2020 ◽  
Author(s):  
bin Yi ◽  
Rui-han Lian ◽  
Ping-an Qi ◽  
Tao Yuan ◽  
Pei-jing Yan ◽  
...  

Abstract Background: Current studies suggest that vitamin D deficiency during pregnancy can produce a certain effect for preterm birth, but there is no research showing whether vitamin D deficiency has a consistent effect in different pregnancies; thus, we conducted a systematic review and meta-analysis of 24 observational studies, grouping them according to the gestational age at the time of serum sampling, to investigate whether vitamin D deficiency in different periods of gestation has different effects on preterm birth and to provide an evidence-based basis for pregnant women to measure and supplement vitamin D. Methods: The databases PubMed-Medline, EMBASE, the Cochrane Library, Web of Science, EBSCO, CBM, and CNKI were searched until July 2019. Two researchers independently assessed the eligibility and quality of studies, and STATA 12.0 software was used for meta-analysis. Result: Seven cohort studies, 13 case-control studies, and four cross-sectional studies were included from 2500 articles by inclusion and exclusion criteria. After adjusting for age, race, and other confounding factors, meta-analysis results showed that vitamin D deficiency in the first trimester, the second trimester and the third trimester did not increase the risk of preterm birth (odds ratio (OR) = 1.01, 95% confidence interval (CI) (0.88, 1.16), P = 0.867; OR = 1.12, 95%CI (0.92, 1.37), P = 0.249; OR = 1.05, 95%CI (0.87, 1.27), P = 0.602). However, there was moderate heterogeneity in the study of vitamin D deficiency in the second trimester, and subgroup analysis suggested that vitamin D deficiency in the second trimester may increase the risk of preterm birth (OR = 1.33, 95%CI (1.15, 1.54), P = 0.000). A sensitivity analysis of the second trimester showed that excluding any one study did not significantly change the results. Conclusions: Vitamin D deficiency in early and late pregnancy may not be associated with preterm birth, while vitamin D deficiency in middle pregnancy is likely to have an important effect on preterm birth. Vitamin D levels should be measured in the second trimester of pregnancy, and vitamin D supplements should be provided if necessary.


2021 ◽  
Vol 01 (1) ◽  
pp. 16-23
Author(s):  
Dina Bitar

Vitamin D and vitamin B12 deficiencies are major public health problems; they may result from inappropriate low exposure to sunlight, autoimmune diseases or diminished intake. These two deficiencies have been extensively studied globally: causes, e"ects, treatment, as well as epidemiology. In Palestine the epidemiology of vitamin D and vitamin B12 deficiencies has not been addressed. This study was undertaken to determine the prevalence of vitamin D and vitamin B12 deficiencies in patients reporting to the West Bank (WB) governmental hospitals in the period between January 2015 and December 2018. It is a retrospective cross-sectional study for the data collected from medical records of patients tested for these deficiencies in 12 WB governmental hospitals for the three years period. Out of 30890 patients tested for vitamin D levels, 88% had insu!cient vitamin D levels (< 30 ng/ml), whereas out of 43532 patients tested for vitamin B12, 19% had insu!cient vitamin B12 levels (< 203 pg/ml). The percentage of patients with insu!cient vitamin D levels is alarming. The percentage of patients with insu!cient vitamin B12 levels falls within ranges reported by other studies in various countries. In conclusion, this study revealed an alarmingly high percentage (88%) of vitamin D deficiency below the reference su!ciency level among patients suspected to have such a deficiency. Around one fifth of the patients tested for vitamin B12 had insu!cient levels. Because testing for vitamin D is costly, we suggest, that medical suspicion of vitamin D deficiency would be adequate to initiate treatment to alleviate the expense, especially in high-risk groups such as elderly women. Future studies have to address major risk factors contributing to these deficiencies that are specific to our community.


Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3089-3089
Author(s):  
Latika Puri ◽  
Nicole M Alberts ◽  
Guolian Kang ◽  
Juan Ding ◽  
Jane S Hankins ◽  
...  

Abstract Background/Aims: Individuals with sickle cell disease (SCD) are at high risk for vitamin D deficiency due to dark skin color, limited physical activity, poor nutrition, and renal dysfunction. In smaller retrospective studies, vitamin D deficiency in SCD was associated with increased frequency of acute pain events and higher opioid use, however the impact of vitamin D deficiency on pain related patient reported outcomes has not been described . Supplementation with high dose vitamin D is shown to be associated with fewer pain days per week and higher physical activity scores in patients with chronic pain. Thus, the objective of our study was to evaluate relationship between vitamin D levels, acute health care utilization and self-reported pain among children with SCD. We hypothesized that vitamin D deficiency is associated with increase health care utilization for pain and patient-reported outcomes for pain. Methods: Patients with SCD (1 to 18 years of age), enrolled in Sickle Cell Clinical Research and Intervention Program (SCCRIP), at St. Jude Children's Research Hospital were included in the study (Hankins et.al., Pediatric Blood and Cancer, 2018). Demographic, clinical and laboratory data were extracted from SCCRIP database. Prospective pain event leading to a hospital visit was analyzed. We analyzed pain-related hospitalizations in two ways: the number of pain-related hospitalizations within 2 years prior to and after vitamin D measurement in a cross-sectional design and longitudinally. Generalized linear regression model was used to examine associations between vitamin D and cross-sectional pain events with adjusting for hydroxyurea use. Generalized linear mixed effect model was used to assess the associations between vitamin D and longitudinal pain events, with adjusting for SCD genotype, sex, age, hydroxyurea use and interaction between age and hydroxyurea use. Pediatric Quality of Life Inventory™ Sickle Cell Disease Module (PedsQL™ SCD) was used to measure pain and pain interference using 1) Pain and Hurt and 2) Pain Impact scales. PedsQL™ SCD assessments include a Likert response scale. Items are reverse -scored and transformed to a 0-100 scale where higher scores indicate better health related quality of life in that scale. Two sample t-test or Wilcoxon rank sum test was used to compare mean scores between the two groups. Results: A total of 799 patients (females, n=398; males, n=401) were included in the study. Mean age (Standard Deviation [SD]), range at time of first vitamin D measurement for entire cohort was 8.7 (4.7), (0.8-18 years). Mean (SD) initial vitamin D level for entire cohort was 19.0 (9.4) ng/dl. Mean (SD) number of pain-related hospitalizations within two years of first vitamin D measurement was higher in the vitamin D deficient group as compared to non deficient group [0.81(1.97) vs 0.66 (1.2), (p=0.0034)]. Longitudinal data analyses showed vitamin D deficiency was associated with increased number of pain related hospitalizations (p=0.0091), after adjusting for covariates listed above (Figure 1a). Mean (SD) scores for Pain and Hurt in vitamin D deficient versus non deficient group were [74.5.7(18.2) versus 83.5(15.6), p &lt; 0.001]. Mean (SD) scores for Pain Impact in vitamin D deficient group as compared to non deficient group were [(66.7 (22.7) versus 75.5 (22.3), p &lt;0.001] (Figure 1b) Conclusion: Results indicated that low vitamin D levels predicted higher frequency of painful events leading to a hospital visit and were associated with higher prevalence of self-reported pain and pain interference. Further studies evaluating mechanisms by which vitamin D influences sickle cell pain are warranted and larger controlled trials can help evaluate the therapeutic efficacy of vitamin D for sickle cell pain. Figure 1 Figure 1. Disclosures Hankins: UpToDate: Consultancy; Bluebird Bio: Consultancy; Vindico Medical Education: Consultancy; Global Blood Therapeutics: Consultancy.


2017 ◽  
Vol 5 (2) ◽  
pp. 177-181
Author(s):  
Ibrahim Abdulrazag AL-Homood ◽  
Iman Sheshah ◽  
Abdel Gaffar A. Mohammed ◽  
Gasim I. Gasim

 AIM: This study aimed to assess the prevalence and determinants of osteoporosis [lumbar spine (LS) and femoral neck (FN)] among patients with type 2 diabetes at King Salman Hospital.MATERIALS AND METHODS: One hundred seventy patients with type 2 diabetes were enrolled in this cross-sectional study in the period from the 1st of January until the 1st of July 2015. Patient selection was based on self-report of the previous diagnosis by a physician, being on an antidiabetic agent, or a fasting glucose of 126 mg/dl as per the American Diabetes Association criteria. A dual energy X-ray absorptiometry scan with the bone mineral density (BMD) categorization based on the WHO cut of levels of T-scores and determination of vitamin D levels were performed. A detailed questionnaire was used to collect demographic data.RESULTS: Out of 170 participants, 50 (29.4%) were diagnosed as having osteoporosis, while 68 (40%) were diagnosed with osteopenia. Age was determined as a risk factor for a decreased BMD in patients with osteopenia (odds ratio (OR) = 1.1, 95% confidence interval (CI) = (1.0-1.1), p = 0.039) and osteoporosis (OR = 1.1, CI = 1.0-1.2, p < 0.001). Similarly, oral hypoglycemic agents (OHA) increased the risk of decreased BMD in osteopenia (OR = 2.6; CI = 1.0-6.7; p = 0.023) as well as osteoporosis, (OR = 3.8; CI = 1.3-10.9; p = 0.013), while vitamin D deficiency increased the risk of osteopenia OR = 3.0; CI = 1.2-7.2; p = 0.012). Increased BMI decreased the risk of both osteopenia and osteoporosis (OR = 0.9; CI = 0.9-0.99; p = 0.031 vs. OR = 0.9; CI = 0.80-0.95; p = 0.003).CONCLUSION: Advanced age, OHA and vitamin D deficiency are determinants of decreased BMD in Saudi women with type 2 diabetes, while an increased BMI protects against low BMD.


2021 ◽  
Vol 10 (44) ◽  
pp. 3730-3735
Author(s):  
Rohit Kumar Agrawal ◽  
Preeti Sharma ◽  
Pradeep Kumar ◽  
Mehek Jaggi ◽  
Rachna Sharma

BACKGROUND Exclusive breastfeeding is recommended up to 6 months of age with all its beneficial effects on child survival. Several studies have shown that adequate intake of vitamin D cannot be met with human milk as the sole source of vitamin D, although risk factors for developing vitamin D deficiency may be low maternal levels of vitamin D, indoor confinement during the day, living at higher altitudes, living in urban areas with tall buildings, air pollution, darker skin pigmentation, use of sunscreen and covering much over the body when outside. An infant who is entirely on breastfeeding and has minimal to no exposure to sunlight is more prone to the development of hypovitaminosis-D. The main purpose of the study was to identify the prevalence & high-risk groups of hypovitaminosis D in exclusively breastfed babies. METHODS It was a cross-sectional observational study consisting of 30 entirely breastfed healthy full-term babies with a birth weight > 2.5 kg. Babies born to mothers with a history of pre-eclampsia, gestational diabetes, antepartum haemorrhage, tuberculosis, and other chronic medical illnesses were excluded from the study. The period of study was from 1st August 2019 to 30th September 2019. Their serum vitamin D3, serum calcium, serum phosphate, and alkaline phosphatase levels were measured using appropriate methods. RESULTS In our study, 25 infants out of 30 came out as vitamin D deficient. The prevalence of vitamin D3 was found to be 83 %. CONCLUSIONS Breastfeeding is of utmost importance but the nutritional status of the mother, proper exposure to the sun, and vitamin D supplementation are the factors that should be taken care of for the prevention of hypovitaminosis D. KEY WORDS Vitamin D3, Hypovitaminosis D, Exclusive Breast Feeding, term babies, infants, Sun Exposure, Rickets


2020 ◽  
Vol 13 (2) ◽  
pp. 35-39
Author(s):  
Wasim Md Mohosin Ul Haque ◽  
Md Faruque Pathan ◽  
MA Sayeed

Background and objectives: Vitamin D deficiency is now a global concern. Industrialization, urbanization and the decreasing participation in outdoor activities, with consequent sunlight deprivation, are thought to be the key factors in the increasing prevalence of vitamin D deficiency among general population of many countries. It is presumed that healthy, adequately sun-exposed people should maintain adequate vitamin D levels. However, studies within this population are scarce. Hence, this study was conducted to find out the actual vitamin D status in healthy, adequately sun-exposed population living in coastal district of Bangladesh. Material and Methods: One hundred and forty healthy fishermen living in costal district of Cox’s Bazar (210 25' North, 910 59' East) of Bangladesh were enrolled in this study. Relevant data and blood samples were collected during August 2018, one of the months with lower zenith angle and higher UV index. Chemiluminescent micro-particle immunoassay (CMIA) was used to measure 25-hydroxy vitamin D3. Other relevant biochemical parameters measured were random blood glucose (RBG), serum creatinine, albumin, calcium, phosphate, alkaline phosphatase and intact parathyroid hormone (iPTH). Results: Mean vitamin D level of the study population was 27.04±7.20 ng/ml. Based on the cut off value of Endocrine Society, 70.7% of the study population had low vitamin D levels of which 26 (18.6%) and 73 (52.1%) were in vitamin D deficient (<20ng/ml) and insufficient (20 – 29.99 ng/ml) categories respectively. Vitamin D level was normal in 41 (29.3%) subjects. There was no significant difference in iPTH level between groups with low and normal vitamin D levels (p>.05, 95%CI= -5.68226, 1.21086). Conclusion: The unexpectedly high prevalence of vitamin D deficiency in this healthy and adequately sun-exposed population raises the question regarding the validity of the current cutoff value being used to assess the vitamin D status of Bangladeshi population. Future studies should be carried out to determine nation-specific, local cutoff values for vitamin D sufficiency. Ibrahim Med. Coll. J. 2019; 13(2): 35-39


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