Jaqueline B Lopes1, Georgea H Fernandes1, Liliam Takayama1, Camille P Figueiredo1, Rosa M R Pereira2. 1. Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. 2. Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. Electronic address: rosamariarp@yahoo.com.
Abstract
OBJECTIVE: To evaluate the prevalence of 25-hydroxyvitamin D insufficiency (25OHD<20 ng/mL) and to develop a predictive model for this status. METHODS: This is a cross-sectional study including 908 community-dwelling older subjects, 18% (158) of which were randomly selected to be a "test" sample, with the remaining (750) composing a "development" sample. A radioimmunoassay technique was used to measure 25OHD levels. Anthropometrical data, information about lifestyle habits and co-morbidities were obtained. Multiple logistic regression models were created. An Index Risk of Vitamin D Insufficiency (IRVDI) was designed and subsequently validated. The performance of this tool was assessed through ROC analysis. RESULTS: The prevalence of 25OHD<20 ng/mL was of 58.0% (CI 95% 51.6-64.6). The clinical independent factors for 25OHD<20 ng/mL were female gender (OR=2.16; 95%CI 1.13-4.13; p=0.020), diabetes (OR=1.84; 95%CI 1.23-2.74; p=0.003) and season (winter/spring) (OR=3.63, 95%CI 2.62-4.88; p<0.001). After statistical adjustments, the IRVDI was able to identify older people at risk for vitamin D insufficiency with a sensitivity of 55.9%, specificity 72.3% and ROC area of 0.685 (p<0.001). CONCLUSIONS: Our results suggest that vitamin D insufficiency is common among Brazilian community-dwelling elderly. Female gender, diabetes and the season (winter/spring) were the important parameters that predicted this status. The clinical use of these parameters can be help to design and target appropriate public health interventions. The IRVDI is a convenient tool for the selection of older people at risk for vitamin D insufficiency.
OBJECTIVE: To evaluate the prevalence of 25-hydroxyvitamin Dinsufficiency (25OHD<20 ng/mL) and to develop a predictive model for this status. METHODS: This is a cross-sectional study including 908 community-dwelling older subjects, 18% (158) of which were randomly selected to be a "test" sample, with the remaining (750) composing a "development" sample. A radioimmunoassay technique was used to measure 25OHD levels. Anthropometrical data, information about lifestyle habits and co-morbidities were obtained. Multiple logistic regression models were created. An Index Risk of Vitamin DInsufficiency (IRVDI) was designed and subsequently validated. The performance of this tool was assessed through ROC analysis. RESULTS: The prevalence of 25OHD<20 ng/mL was of 58.0% (CI 95% 51.6-64.6). The clinical independent factors for 25OHD<20 ng/mL were female gender (OR=2.16; 95%CI 1.13-4.13; p=0.020), diabetes (OR=1.84; 95%CI 1.23-2.74; p=0.003) and season (winter/spring) (OR=3.63, 95%CI 2.62-4.88; p<0.001). After statistical adjustments, the IRVDI was able to identify older people at risk for vitamin Dinsufficiency with a sensitivity of 55.9%, specificity 72.3% and ROC area of 0.685 (p<0.001). CONCLUSIONS: Our results suggest that vitamin Dinsufficiency is common among Brazilian community-dwelling elderly. Female gender, diabetes and the season (winter/spring) were the important parameters that predicted this status. The clinical use of these parameters can be help to design and target appropriate public health interventions. The IRVDI is a convenient tool for the selection of older people at risk for vitamin Dinsufficiency.
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