Factors Associated with Vitamin D Deficiency in European Adolescents: The HELENA Study (original) (raw)
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European Journal of Clinical Nutrition, 2021
Background/objectives To provide age- and sex-specific percentile curves of serum 25-hydroxyvitamin D (25(OH)D) by determinants from 3-<15 year-old European children, and to analyse how modifiable determinants influence 25(OH)D. Subjects/methods Serum samples were collected from children of eight European countries participating in the multicenter IDEFICS/I.Family cohort studies. Serum 25(OH)D concentrations were analysed in a central lab by a chemiluminescence assay and the values from 2171 children (N = 3606 measurements) were used to estimate percentile curves using the generalized additive model for location, scale and shape. The association of 25(OH)D with time spent outdoors was investigated considering sex, age, country, parental education, BMI z score, UV radiation, and dietary vitamin D in regressions models. Results The age- and sex-specific 5th and 95th percentiles of 25(OH)D ranged from 16.5 to 73.3 and 20.8 to 79.3 nmol/l in girls and boys, respectively. A total of 6...
BMC Public Health, 2009
Background: Vitamin D has a wide variety of physiological functions in the human body. There is increasing evidence that low serum levels of this vitamin have an important role in the pathogenesis of different skeletal and extra-skeletal diseases. Vitamin D deficiency and insufficiency is common at northern latitudes. There are few population-based studies in the northern European region looking at the issue in a wider age group. We aimed to measure Vitamin D level in the general population of Estonia (latitude 59°N), a North-European country where dairy products are not fortified with vitamin D.
Pediatrics, 2010
OBJECTIVES: The objectives were to characterize the vitamin D status of black and white adolescents residing in the southeastern United States (latitude: approximately 33 degrees N) and to investigate relationships with adiposity.METHODS: Plasma 25-hydroxyvitamin D levels were measured with liquid chromatography-tandem mass spectroscopy for 559 adolescents 14 to 18 years of age (45% black and 49% female). Fat tissues, physical activity, and cardiovascular fitness also were measured.RESULTS: The overall prevalences of vitamin D insufficiency (<75 nmol/L) and deficiency (< or = 50 nmol/L) were 56.4% and 28.8%, respectively. Black versus white subjects had significantly lower plasma 25-hydroxyvitamin D levels in every season (winter, 35.9 + or - 2.5 vs 77.4 + or - 2.7 nmol/L; spring, 46.4 + or - 3.5 vs 101.3 + or - 3.5 nmol/L; summer, 50.7 + or - 4.0 vs 104.3 + or - 4.0 nmol/L; autumn, 54.4 + or - 4.0 vs 96.8 + or - 2.7 nmol/L). With adjustment for age, gender, race, season, height, and sexual maturation, there were significant inverse correlations between 25-hydroxyvitamin D levels and all adiposity measurements, including BMI percentile (P = .02), waist circumference (P < .01), total fat mass (P < .01), percentage of body fat (P < .01), visceral adipose tissue (P = .015), and subcutaneous abdominal adipose tissue (P = .039). There were significant positive associations between 25-hydroxyvitamin D levels and vigorous physical activity (P < .01) and cardiovascular fitness (P = .025).CONCLUSIONS: Low vitamin D status is prevalent among adolescents living in a year-round sunny climate, particularly among black youths. The relationships between 25-hydroxyvitamin D levels, adiposity, physical activity, and fitness seem to be present in adolescence.
Vitamin D deficiency and lifestyle risk factors in a Norwegian adolescent population
Scandinavian journal of public health, 2014
The aim was to study vitamin D status in a healthy adolescent Norwegian population at 69°N. The data presented come from The Tromsø Study: Fit Futures, during the school year 2010/2011 (not including the summer months), where 1,038 (92% of those invited) participated. Physical examinations, questionnaires and blood samples were collected, and serum 25-hydroxyvitamin D (25(OH)D) were analyzed using LC-MS/MS. RESULTS are presented from 475 boys and 415 girls (15-18 years old) with available blood samples. A total of 60.2% had vitamin D deficiency or insufficiency (serum 25(OH)D <50 nmol/l), 16.5% were deficient (<25 nmol/l) and 1.6% had severe vitamin D deficiency (<12.5 nmol/l). Only 12.4% had levels >75 nmol/l. A significant gender difference with a mean (SD) serum 25(OH)D level of 40.5 (20.5) nmol/l in boys and 54.2 (23.2) nmol/l in girls (p <0.01) was present. Furthermore, 51.3% of girls had levels >50 nmol/l in comparison to 29.7% of boys (p <0.01). There was...
British Journal of Nutrition, 2014
The impact of the familial relationship on vitamin D status has not been investigated previously. The objective of the present cross-sectional study was to assess serum 25-hydroxyvitamin D (25(OH)D) concentration and its determinants in children and adults among families in late summer in Denmark (568N). Data obtained from 755 apparently healthy children (4 -17 years) and adults (18 -60 years) recruited as families (n 200) in the VitmaD study were analysed. Blood samples were collected in September -October, and serum 25(OH)D concentration was measured by liquid chromatography -tandem MS. Information on potential determinants was obtained using questionnaires. The geometric mean serum 25(OH)D concentration was 72·1 (interquartile range 61·5 -86·7) nmol/l (range 9 -162 nmol/l), with 9 % of the subjects having 25(OH)D concentrations ,50 nmol/l. The intra-family correlation was 0·27 in all subjects, 0·24 in the adults and 0·42 in the children. Serum 25(OH)D concentration was negatively associated with BMI (P,0·001) and positively associated with dietary vitamin D intake (P¼0·008), multivitamin use (P¼ 0·019), solarium use (P¼ 0·006), outdoor stay (P¼ 0·001), sun preference (P¼0·002) and sun vacation (P,0·001), but was not associated with lifestyle-related factors in the adults when these were assessed together with the other determinants. In conclusion, the majority of children and adults among the families had serum 25(OH)D concentrations .50 nmol/l in late summer in Denmark. Both dietary and sun-related factors were determinants of vitamin D status and the familial component was stronger for the children than for the adults. Abbreviations: 25(OH)D, 25-hydroxyvitamin D; DEQAS, Vitamin D External Quality Assessment Scheme; IQR, interquartile range; LC -MS/MS, liquid chromatography-tandem MS; NIST, National Institute of Standards and Technology; PTH, parathyroid hormone.
British Journal of Nutrition, 2012
An adequate vitamin D status is essential during childhood and adolescence, for its important role in cell growth, skeletal structure and development. It also reduces the risk of conditions such as CVD, osteoporosis, diabetes mellitus, infections and autoimmune disease. As comparable data on the European level are lacking, assessment of vitamin D concentrations was included in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. Fasting blood samples were obtained from a subsample of 1006 adolescents (470 males; 46·8 %) with an age range of 12·5-17·5 years, selected in the ten HELENA cities in the nine European countries participating in this cross-sectional study, and analysed for 25-hydroxycholecalciferol (25(OH)D) by ELISA using EDTA plasma. As specific reference values for adolescents are missing, percentile distribution were computed by age and sex. Median 25(OH)D levels for the whole population were 57·1 nmol/l (5th percentile 24·3 nmol/l, 95th percentile 99·05 nmol/l). Vitamin D status was classified into four groups according to international guidelines (sufficiency/optimal levels $75 nmol/l; insufficiency 50 -75 nmol/l; deficiency 27·5 -49·99 nmol/l and severe deficiency ,27·5 nmol/l). About 80 % of the sample had suboptimal levels (39 % had insufficient, 27 % deficient and 15 % severely deficient levels). Vitamin D concentrations increased with age (P,0·01) and tended to decrease according to BMI. Geographical differences were also identified. Our study results indicate that vitamin D deficiency is a highly prevalent condition in European adolescents and should be a matter of concern for public health authorities.
European Journal of Clinical Nutrition, 2014
BACKGROUND/OBJECTIVES: To study the relationship of winter 25-hydroxycholecalciferol (25-OHD) levels with age, education, place of residency, marital status and body mass index (BMI) as they may affect sun exposure, vitamin D synthesis and metabolism. SUBJECTS/METHODS: Subjects (1952) answered a structured questionnaire concerning education, marital status and smoking; and body weight/height, and parathyroid hormone and 25-OHD were measured. RESULTS: 25-OHD levels were higher in the males with elementary and secondary education compared with higher education (46.8 ± 18.5 and 43.7 ± 16 vs 39.9 ± 15.3 nmol/l, P o0.01). Vitamin D deficiency was more prevalent (16.7%, (13.1-20.2) vs 10.8%, (8.4-13.2), P = 0.08) and sufficiency was less prevalent (24.6% (20-29.2) vs 33.7%, (29.5-37.8), P = 0.005) in those with higher than secondary education. No differences were found among the females. Male smokers had lower 25-OHD than nonsmokers (40.2 ± 16.6 vs 43.6 ± 15.7 nmol/l, P = 0.004). Deficiency was more prevalent in the male smokers than nonsmokers with secondary and higher education (secondary 16.6%, (10.1-22.4) vs 8.2%, (5.1-11.3), P = 0.006; higher 27.4%, (17.7-37.1) vs 13.2%, (9.0-17.5), P = 0.003). 25-OHD was lower in the obese than in the normal-weight females (34.6 ± 16.2 vs 38.2 ± 17.8 nmol/l, analysis of variance, P = 0.014), but not males. Marital status was not related to 25-OHD. Only in the urban residents, increasing BMI in the young females increased the risk for vitamin D deficiency by 1%, and smoking had an odds ratio of 1.99 (1.05-3.78) in the young and 2.5 (1.07-5.75) in the middle-aged males. CONCLUSIONS: Smoking and higher education in the males and obesity in the females were factors for vitamin D deficiency among Bulgarian urban population.
Levels of Vitamin D and the Association with Body Composition in Adolescents
This is an observational, cross-sectional study evaluating adolescents from a public school in Curitiba, Brazil (25°25′S 49°15′W). In 2008, 834 students were enrolled at that school, of which 202 were recruited to the study aleatore (CI 95%, type I error 15%, 20% addition to account for possible losses to follow-up) . Were excluded from the study participants with pre-existing diseases such as diabetes mellitus, rheumatologycal diseases, hyperthyroidism, malignancies, asthma, chronic diarrhea and osteo-metabolic diseases. Four students decided not participate in the study, and a total of 198 adolescents (53% females, 47% males) were included in the final analysis.
Analysis of 25-Hydroxyvitamin D Status According to Age, Gender, and Seasonal Variation
Journal of Clinical Laboratory Analysis, 2016
Background: The effects of age, gender, and seasonal variation on human levels of 25-hydroxyvitamin D (25(OH)D) are not well understood. In this study, we aimed to investigate 25(OH)D status according to these factors in a Korean population. Methods: A total of 303,943 serum 25(OH)D levels were measured using an electrochemiluminescence immunoassay between October 2011 and May 2014. Potential participants were ineligible for the study if they had significant renal, hepatic, or thyroid dysfunction, as well as any major ongoing disease that could influence serum 25(OH)D levels. Results: A total of 95,137 subjects (49,662 men and 45,475 women) were included in this study. The mean 25(OH)D levels were higher in men (42.4 nmol/l) than in women (32.9 nmol/l, P < 0.001). Among the men and women, 73.0% and 88.9%, respectively, had 25(OH)D levels <50 nmol/l, whereas only 3.8% of men and 1.4% of women had levels >75 nmol/l. The highest mean 25(OH)D value was noted in individuals aged ࣙ70 for both genders. The proportion of those with 25(OH)D levels <50 nmol/l appeared to be higher among younger subjects (P < 0.001). Lastly, there were significant differences between 25(OH)D levels in individuals during summer to fall and winter to spring in both genders, indicating seasonal periodicity (P < 0.001). Conclusions: Serum 25(OH)D status varied according to gender, age, and season. Therefore, analyses of vitamin D status require individualized gender, age, and seasonally adjusted thresholds. Clinicians should consider these factors when determining optimal serum 25(OH)D levels in clinical practice. J. Clin. Lab. Anal.