Prevalence of Vitamin D Deficiency and Insufficiency in Kosovo Population

Zana Baruti-Gafurri; Ardita Kafexholli; Bardha Dervishi; Rilind Sylaj; Krenare Shabani; Dijon Musliu

doi:10.3889/oamjms.2022.8808

Authors

Zana Baruti-Gafurri Clinic of Medical Biochemistry
Ardita Kafexholli Faculty of Medicine
Bardha Dervishi Faculty of Medicine
Rilind Sylaj Department of Anatomy
Krenare Shabani Department of Anatomy
Dijon Musliu Department of Anatomy

DOI:

https://doi.org/10.3889/oamjms.2022.8808

Keywords:

25(OH)D, Vitamin D insufficiency, Vitamin D deficiency

Abstract

BACKGROUND: Vitamin D deficiency is a global health problem, but it is not known about its status in the Kosovo population.

AIM: The purpose of this study is to determine the status of Vitamin D deficiency and insufficiency in our population.

MATERIALS AND METHODS: Data collection was done from January 2020 to July 2021, during which period blood samples were collected. The sampling was done for 769 selected subjects and statistical data (frequency, mean values, and standard deviation) have been analyzed for 25-hydroxyvitamin D [25(OH)D] concentration. They were categorized by age group, gender, and level of 25(OH)D. The prevalence and percentage of Vitamin D deficiency and insufficiency in the study population were evaluated.

RESULTS: The mean concentration of 25(OH)D in the serum of the study group was 18.3 ng/ml. The mean value was significantly lower for females when compared for that of males (17.89 and 19.58 ng/ml, respectively), with p < 0.0035, but there was no significant difference between age groups. The level of 25(OH)D less than 20 ng/ml was observed in 62% of the cases in our study population with a slight difference between female (63.6%) and male (57.2%) group. The age group of >60 had 25(OH)D deficiency in 62.3% of cases when compared to other age group categories. Vitamin D deficiency was present in 20.2% of cases; meanwhile, its insufficiency was present in 41.9% of cases. Vitamin D deficiency was observed in 21.1% of females and 17.1% of males, while 42.4% of females, respectively, and 40.1% of males had Vitamin D insufficiency.

CONCLUSION: The mean values of 25(OH)D in the study population are relatively low, which corresponds to significant Vitamin D deficiency and insufficiency in all age groups, and which may also have serious implications for their overall health.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Hasegawa Y, Miyai K, Takeda R. Updates on rickets and osteomalacia: Pathogenesis and pathophysiology of rickets. Clin Calcium. 2013;23(10):1405-12. PMid:24076637

Berry JL, Davies M, Mee AP. Vitamin D metabolism, rickets, and osteomalacia. Semin Musculoskelet Radiol. 2002;6(3):173-82. https://doi.org/10.1055/s-2002-36714 DOI: https://doi.org/10.1055/s-2002-36714

Bikle DD. Role of Vitamin D, its metabolites, and analogs in the management of osteoporosis. Rheum Dis Clin North Am. 1994;20(3):759-75. PMid:7984788 DOI: https://doi.org/10.1016/S0889-857X(21)00359-8

Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25-hydroxyvitamin D and risk of myocardial infarction in men. Arch Intern Med. 2008;168(11):1174-80. https://doi.org/10.1001/archinte.168.11.1174 DOI: https://doi.org/10.1001/archinte.168.11.1174

Dobnig H, Pilz S, Scharnagl H, Renner W, Seelhorst U, Wellnitz B, et al. Independent association of low serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels with all-cause and cardiovascular mortality. Arch Intern Med. 2008;168(12):1340-9. https://doi.org/10.1001/archinte.168.12.1340 PMid:18574092 DOI: https://doi.org/10.1001/archinte.168.12.1340

Giovannucci E, Liu Y, Rimm EB, Hollis BW, Fuchs CS, Stampfer MJ, et al. Prospective study of predictors of Vitamin D status and cancer incidence and mortality in men. J Natl Cancer Inst. 2006;98(7):451-9. https://doi.org/10.1093/jnci/djj101 PMid:16595781 DOI: https://doi.org/10.1093/jnci/djj101

Garland CF, Garland FC, Gorham ED, Lipkin M, Newmark H, Mohr SB, et al. The role of Vitamin D in cancer prevention. Am J Public Health. 2006;96(2):252-61. https://doi.org/10.2105/AJPH.2004.045260 PMid:16380576 DOI: https://doi.org/10.2105/AJPH.2004.045260

Lin J, Manson JE, Lee IM, Cook NR, Buring JE, Zhang SM. Intakes of calcium and Vitamin D and breast cancer risk in women. Arch Intern Med. 2007;167(10):1050-9. https://doi.org/10.1001/archinte.167.10.1050 PMid:17533208 DOI: https://doi.org/10.1001/archinte.167.10.1050

Cannell JJ, Vieth R, Umhau JC, Holick MF, Grant WB, Madronich S, et al. Epidemic influenza and Vitamin D. Epidemiol Infect. 2006;134(6):1129-40. https://doi.org/10.1017/S0950268806007175 PMid:16959053 DOI: https://doi.org/10.1017/S0950268806007175

Laaksi I, Ruohola JP, Tuohimaa P, Auvinen A, Haataja R, Pihlajamäki H, et al. An association of serum Vitamin D concentrations <40 nmol/L with acute respiratory tract infection in young Finnish men. Am J Clin Nutr. 2007;86(3):714-7. https://doi.org/10.1093/ajcn/86.3.714 PMid:17823437 DOI: https://doi.org/10.1093/ajcn/86.3.714

Harkness LS, Bonny AE. Calcium and Vitamin D status in the adolescent: Key roles for bone, body weight, glucose tolerance, and estrogen biosynthesis. J Pediatr Adolesc Gynaecol. 2005;18(5):305-11. https://doi.org/10.1016/j.jpag.2005.06.002 PMid:16202933 DOI: https://doi.org/10.1016/j.jpag.2005.06.002

Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and B cell dysfunction. Am J Clin Nutr. 2004;79(5):820-5. https://doi.org/10.1093/ajcn/79.5.820 PMid:15113720 DOI: https://doi.org/10.1093/ajcn/79.5.820

Holick MF. Vitamin D: Importance in the prevention of cancers, Type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr. 2004;79(3):362-71. https://doi.org/10.1093/ajcn/79.3.362 PMid:14985208 DOI: https://doi.org/10.1093/ajcn/79.3.362

Zhang C, Qiu C, Hu FB, David RM, van Dam RM, Bralley A, et al. Maternal plasma 25-hydroxyvitamin D concentrations and the risk for gestational diabetes mellitus. PLoS One. 2008;3(11):e3753. https://doi.org/10.1371/journal.pone.0003753 PMid:19015731 DOI: https://doi.org/10.1371/journal.pone.0003753

Bodnar LM, Catov JM, Simhan HN, Holick MF, Powers RW, Roberts JM. Maternal Vitamin D deficiency increases the risk of preeclampsia. J Clin Endocrinol Metab. 2007;92(9):3517-22. https://doi.org/10.1210/jc.2007-0718 PMid:17535985 DOI: https://doi.org/10.1210/jc.2007-0718

Fuller KE. Low birth-weight infants: The continuing ethnic disparity and the interaction of biology and environment. Ethn Dis. 2000;10(3):432-45. PMid:11110360

Liu PT, Stenger S, Li H, et al. Toll-like receptor triggering of Vitamin D-mediated human antimicrobial response. Science. 2006;311(5768):1770-3. https://doi.org/10.1126/science.1123933 PMid:16497887 DOI: https://doi.org/10.1126/science.1123933

Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: Results of a randomized trial. Am J Clin Nutr 2007;85(6):1586-91. https://doi.org/10.1093/ajcn/85.6.1586 PMid:17556697 DOI: https://doi.org/10.1093/ajcn/85.6.1586

Autier P, Gandini S. Vitamin D supplementation and total mortality: A meta-analysis of randomized controlled trials. Arch Intern Med. 2007;167(16):1730-7. https://doi.org/10.1001/archinte.167.16.1730 PMid:17846391 DOI: https://doi.org/10.1001/archinte.167.16.1730

Avenell A, Cook JA, Maclennan GS, Macpherson GC. Vitamin D supplementation to prevent infections. Age Ageing. 2007;36(5):574-7. https://doi.org/10.1093/ageing/afm091 PMid:17702768 DOI: https://doi.org/10.1093/ageing/afm091

Martineau AR, Wilkinson RJ, Wilkinson KA, Newton SM, Kampmann B, Hall BM, et al. A single dose of Vitamin D enhances immunity to mycobacteria. Am J Respir Crit Care Med. 2007;176(2):208-13. https://doi.org/10.1164/rccm.200701-007OC PMid:17463418 DOI: https://doi.org/10.1164/rccm.200701-007OC

Standing Committee on the Scientific Evaluation of Dietary Reference Intakes Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: National Academy Press; 1999. p. 250-87.

Stroud ML, Stilgoe S, Stott VE, Alhabian O, Salman K. Vitamin D a review. Aust Fam Physician. 2008;37(12):1002-5. PMid:19142273

National Institutes of Health. “Dietary Supplement Fact Sheet: Vitamin D”. National Institutes of Health; 2007. DOI: https://doi.org/10.1002/9780470373699.speced1443

Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266-81. https://doi.org/10.1056/NEJMra070553 PMid:17634462 DOI: https://doi.org/10.1056/NEJMra070553

Lips P. Which circulating level of 25-hydroxyvitamin D is appropriate? J Steroid Biochem Mol Biol. 2004;89-90:611-4. https://doi.org/10.1016/j.jsbmb.2004.03.040 PMid:15225848 DOI: https://doi.org/10.1016/j.jsbmb.2004.03.040

Holick MF. Vitamin D status: Measurement, interpretation, and clinical application. Ann Epidemiol. 2009;19(2):73-8. https://doi.org/10.1016/j.annepidem.2007.12.001 PMid:18329892 DOI: https://doi.org/10.1016/j.annepidem.2007.12.001

Pilz S, Zittermann A, Trummer C, Theiler-Schwetz V, Lerchbaum E, Keppel MH, et al. Vitamin D testing and treatment: A narrative review of current evidence. Endocrine Connections. 2019;8:R27-43. https://doi.org/10.1530/EC-18-0432 PMid:30650061 DOI: https://doi.org/10.1530/EC-18-0432

Hilger J, Friedel A, Herr R, Rausch T, Roos F, Wahl DA, et al. A systematic review of vitamin D status in populations worldwide. Br J Nutr. 2014;111(1):23-45. https://doi.org/10.1017/S0007114513001840 PMid:23930771 DOI: https://doi.org/10.1017/S0007114513001840

Ginde AA, Liu MC, Camargo CA Jr. Demographic differences and trends of Vitamin D insufficiency in the US population, 1988-2004. Arch Intern Med. 2009;169(6):626-32. https://doi.org/10.1001/archinternmed.2008.604 PMid:19307527 DOI: https://doi.org/10.1001/archinternmed.2008.604

Langlois K, Greene-Finestone L, Little J, Hidiroglou N, Whiting S. Vitamin D status of Canadians as measured in the 2007 to 2009 Canadian health measures survey. Health Rep. 2010;21(1):47-55. PMid:20426226

Melhus H, Snellman G, Gedeborg R, Byberg L, Berglund L, Mallmin H, et al. Plasma 25-hydroxyvitamin D levels and fracture risk in a community-based cohort of elderly men in Sweden. J Clin Endocrinol Metab 2010;95(6):2637-45. https://doi.org/10.1210/jc.2009-2699 PMid:20332246 DOI: https://doi.org/10.1210/jc.2009-2699

Laktasic-Zerjavic N, Korsic M, Crncevic-Orlic Z, Kovac Z, Polasek O, Soldo-Juresa D. Vitamin D status, dependence on age, and seasonal variations in the concentration of Vitamin D in Croatian postmenopausal women initially screened for osteoporosis. Clin Rheumatol. 2010;29(8):861-7. https://doi.org/10.1007/s10067-010-1409-3 PMid:20204667 DOI: https://doi.org/10.1007/s10067-010-1409-3

Van der Wielen RP, Lowik MR, van den BH, de Groot LC, Haller J, Moreiras O, et al. Serum Vitamin D concentrations among elderly people in Europe. Lancet. 1995;346(8969):207-10. https://doi.org/10.1016/s0140-6736(95)91266-5 PMid:7616799 DOI: https://doi.org/10.1016/S0140-6736(95)91266-5

van Schoor NM, Lips P. Worldwide Vitamin D status. Best Pract Res Clin Endocrinol Metab. 2011;25(4):671-80. https://doi.org/10.1016/j.beem.2011.06.007 PMid:21872807 DOI: https://doi.org/10.1016/j.beem.2011.06.007

Bakhtiyarova S, Lesnyak O, Kyznesova N, Blankenstein MA, Lips P. Vitamin D status among patients with hip fracture and elderly control subjects in Yekaterinburg, Russia. Osteoporosis Int. 2006;17(3):441-6. https://doi.org/10.1007/s00198-005-0006-9 PMid:16328605 DOI: https://doi.org/10.1007/s00198-005-0006-9

Fraser DR. Vitamin D-deficiency in Asia. J Steroid Biochem Mol Biol. 2004;89-90(1-5):491-5. https://doi.org/10.1016/j.jsbmb.2004.03.057 PMid:15225826 DOI: https://doi.org/10.1016/j.jsbmb.2004.03.057

Rahman SA, Chee WS, Yassin Z, Chan SP. Vitamin D status among postmenopausal Malaysian women. Asia Pac J Clin Nutr. 2004;13(3):255-60. PMid:15331337

Nakamura K. Vitamin D insufficiency in Japanese populations: From the viewpoint of the prevention of osteoporosis. J Bone Miner Metab. 2006;24:1-6. https://doi.org/10.1007/s00774-005-0637-0 PMid:16369890 DOI: https://doi.org/10.1007/s00774-005-0637-0

Sachan A, Gupta R, Das V, Agarwal A, Awasthi PK, Bhatia V. High prevalence of Vitamin D deficiency among pregnant women and their newborns in Northern India. Am J Clin Nutr. 2005;81(5):1060-4. https://doi.org/10.1093/ajcn/81.5.1060 PMid:15883429 DOI: https://doi.org/10.1093/ajcn/81.5.1060

Ginde AA, Sullivan AF, Mansbach JM, Camargo CA Jr. Vitamin D insufficiency in pregnant and non-pregnant women of childbearing age in the United States. Am J Obstet Gynaecol. 2010;202(5):436-8. https://doi.org/10.1016/j.ajog.2009.11.036 PMid:20060512 DOI: https://doi.org/10.1016/j.ajog.2009.11.036

Bowyer L, Catling-Paull C, Diamond T, Homer C, Davis G, Craig ME. Vitamin D, PTH and calcium levels in pregnant women and their neonates. Clin Endocrinol (Oxf). 2009;70(3):372-7. https://doi.org/10.1111/j.1365-2265.2008.03316.x PMid:18573121 DOI: https://doi.org/10.1111/j.1365-2265.2008.03316.x

Mansbach JM, Ginde AA, Camargo CA Jr. Serum 25-hydroxyvitamin D levels among US children aged 1 to 11 years: Do children need more Vitamin D? Pediatrics. 2009;124(5):1404-10. https://doi.org/10.1542/peds.2008-2041 PMid:19951983 DOI: https://doi.org/10.1542/peds.2008-2041

Prentice A. Vitamin D deficiency: A global perspective. Nutr Rev. 2008;66(10 Suppl 2):S153-64. DOI: https://doi.org/10.1111/j.1753-4887.2008.00100.x

Munns C, Zacharin MR, Rodda CP, Batch JA, Morley R, Cranswick NE, et al. Prevention and treatment of infant and childhood Vitamin D deficiency in Australia and New Zealand: A consensus statement. Med J Aust. 2006;185(5):268-72. https://doi.org/10.5694/j.1326-5377.2006.tb00558.x PMid:16948623 DOI: https://doi.org/10.5694/j.1326-5377.2006.tb00558.x

Portela ML, Monico A, Barahona A, Dupraz H, Gonzales-Chaves MM, Zeni SN. Comparative 25-OH-vitamin D level in institutionalized women older than 65 years from two cities in Spain and Argentina having a similar solar radiation index. Nutrition. 2010;26(3):283-9. https://doi.org/10.1016/j.nut.2009.04.022 PMid:19819110 DOI: https://doi.org/10.1016/j.nut.2009.04.022

Larijani B, Hossein-Nezhad A, Feizabad E, Maghbooli Z, Adibi H, Ramezani M, et al. Vitamin D deficiency, bone turnover markers and causative factors among adolescents: A crosssectional study. J Diabetes Metab Disord. 2016;15:46. https://doi.org/10.1186/s40200-016-0266-2 PMid:27752482 DOI: https://doi.org/10.1186/s40200-016-0266-2