Catia Duarte1,2, Helena Carvalheiro3,4, Ana M Rodrigues5,6, Sara S Dias5,7, Andréa Marques3,8, Tânia Santiago3,9, Helena Canhão5,10,11, Jaime Cunha Branco5,12, José António Pereira da Silva3,9. 1. Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra, Praceita Prof. Mota Pinto, 3000-075, Coimbra, Portugal. catiacmduarte@gmail.com. 2. Coimbra Institute for Clinical and Biomedical Research (iCBR) - Faculty of Medicine, University of Coimbra, Azinhaga Santa Comba, Celas, 3000-548, Coimbra, Portugal. catiacmduarte@gmail.com. 3. Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra, Praceita Prof. Mota Pinto, 3000-075, Coimbra, Portugal. 4. Center for Neuroscience and Cell Biology, Faculdade de Medicina, University of Coimbra, Rua Larga, Pólo I,1°, 3004-504, Coimbra, Portugal. 5. EpiDoC Unit, CEDOC, NOVA Medical School, Universidade Nova de Lisboa (NMS-UNL), Rua Câmara Pestana, n°6, 6-A Edificio CEDOC II, 1150-082, Lisbon, Portugal. 6. Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal. 7. Center for Innovative Care and Health Technology (ciTechCare), Escola Superior de Saúde de Leiria (ESSLei), Instituto Politécnico de Leiria (IPLeiria), Campus 2- Morro do Lena- Alto do Vieiro, Apartado 4137, 2411-901, Leiria, Portugal. 8. Health Sciences Research Unit: Nursing Coimbra, Coimbra Nursing School, ESEnfc, Avenida Bissaya Barreto, Apartado 700, 3046-851, Coimbra, Portugal. 9. Coimbra Institute for Clinical and Biomedical Research (iCBR) - Faculty of Medicine, University of Coimbra, Azinhaga Santa Comba, Celas, 3000-548, Coimbra, Portugal. 10. National School of Public Health, Universidade Nova de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal. 11. CHLC - Hospital Curry Cabral, Rua da Beneficência n.° 8, 1069-166, Lisbon, Portugal. 12. Rheumatology Department, Centro Hospitalar de Lisboa Ocidental | Egas Moniz Hospital, Rua da Junqueira, 126, 1349-019, Lisbon, Portugal.
Abstract
Vitamin D deficiency is prevalent worldwide, but its prevalence is unknown in adult Portuguese population. In Portugal, 66% of adults present Vitamin D insufficiency/deficiency. Winter, living in Azores, older age, and obesity were the most important risk factors. It highlights the need of strategies to prevent vitamin D deficiency in Portugal. OBJECTIVE: To estimate the prevalence and risk factors of vitamin D deficiency in the adult Portuguese population. METHODS: Adults (≥ 18 years old) from the EpiReumaPt Study (2011-2013) were included. Standardized questionnaires on socio-demographic and lifestyle features were obtained. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were evaluated using ADVIA Centaur VitD competitive immunoassay (Siemens Healthineers) in 2015-2017 as 25 (OH)D Level 0: ≤ 10 ng/mL; Level 1: 11-19 ng/mL; Level 2: 20-29 ng/mL, and Level 3: ≥ 30 ng/mL. Weighted multinomial regression analysis was conducted to evaluate the association between socio-demographic and lifestyle variables and vitamin D status. RESULTS: Based on weighted analysis, the estimated prevalence of levels of 25(OH)D ≤ 10, < 20, and < 30 ng/mL was 21.2, 66.6, and 96.4%, respectively. The strongest independent predictors of serum 25 (OH)D ≤ 10 ng/mL were living in the Azores archipelagos (OR 9.39; 95%CI 1.27-69.6) and having the blood sample collection in winter (OR 18.53; 95%CI 7.83-43.87) or spring (11.55; 95%CI 5.18-25.74). Other significant predictors included older age (OR 5.65, 95%CI 2.08-15.35), obesity (OR 2.61; 95%CI 1.35-5.08), current smoking (OR 2.33; 95%CI 1.23-4.43), and female gender (OR 1.9, 95%CI 1.1-3.28). Conversely, physical exercise (OR 0.48, 95%CI 0.28-0.81) and occasional alcohol intake (OR 0.48, 95%CI 0.29-0.81) were associated with a lower risk of 25(OH)D ≤ 10 ng/mL. CONCLUSION: Vitamin D deficiency/insufficiency [25(OH)D < 20 ng/ml] is highly prevalent in Portugal, affecting > 60% of all Portuguese adults, with strong geographical and seasonal variation. This study highlights the need to critically assess the relevance of vitamin D deficiency as a public health problem and the urgent need for a wide and scientifically robust debate about the most appropriate interventions at the individual and societal levels.
Vitamin D deficiency is prevalent worldwide, but its prevalence is unknown in adult Portuguese population. In Portugal, 66% of adults present Vitamin Dinsufficiency/deficiency. Winter, living in Azores, older age, and obesity were the most important risk factors. It highlights the need of strategies to prevent vitamin D deficiency in Portugal. OBJECTIVE: To estimate the prevalence and risk factors of vitamin D deficiency in the adult Portuguese population. METHODS: Adults (≥ 18 years old) from the EpiReumaPt Study (2011-2013) were included. Standardized questionnaires on socio-demographic and lifestyle features were obtained. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were evaluated using ADVIA Centaur VitD competitive immunoassay (Siemens Healthineers) in 2015-2017 as 25 (OH)D Level 0: ≤ 10 ng/mL; Level 1: 11-19 ng/mL; Level 2: 20-29 ng/mL, and Level 3: ≥ 30 ng/mL. Weighted multinomial regression analysis was conducted to evaluate the association between socio-demographic and lifestyle variables and vitamin D status. RESULTS: Based on weighted analysis, the estimated prevalence of levels of 25(OH)D ≤ 10, < 20, and < 30 ng/mL was 21.2, 66.6, and 96.4%, respectively. The strongest independent predictors of serum 25 (OH)D ≤ 10 ng/mL were living in the Azores archipelagos (OR 9.39; 95%CI 1.27-69.6) and having the blood sample collection in winter (OR 18.53; 95%CI 7.83-43.87) or spring (11.55; 95%CI 5.18-25.74). Other significant predictors included older age (OR 5.65, 95%CI 2.08-15.35), obesity (OR 2.61; 95%CI 1.35-5.08), current smoking (OR 2.33; 95%CI 1.23-4.43), and female gender (OR 1.9, 95%CI 1.1-3.28). Conversely, physical exercise (OR 0.48, 95%CI 0.28-0.81) and occasional alcohol intake (OR 0.48, 95%CI 0.29-0.81) were associated with a lower risk of 25(OH)D ≤ 10 ng/mL. CONCLUSION:Vitamin Ddeficiency/insufficiency [25(OH)D < 20 ng/ml] is highly prevalent in Portugal, affecting > 60% of all Portuguese adults, with strong geographical and seasonal variation. This study highlights the need to critically assess the relevance of vitamin D deficiency as a public health problem and the urgent need for a wide and scientifically robust debate about the most appropriate interventions at the individual and societal levels.
Entities:
Keywords:
25-hydroxyvitamin D; Vitamin D deficiency; Vitamin D insufficiency; Vitamin D, prevalence, Portugal
Authors: Gregorio Bevilacqua; Faidra Laskou; Michael A Clynes; Karen A Jameson; Barbara J Boucher; Kate Noonan; Cyrus Cooper; Elaine M Dennison Journal: Metabol Open Date: 2021-10-26