J Pediatr Endocr Met 2014; 27(7-8): 595–602
Mehdi Ebrahimi, Patricia Khashayar, Abbasali Keshtkar*, Koroush Etemad, Mahboubeh Dini, Zahra Mohammadi, Hossein Ebrahimi, Reza Chaman and Bagher Larijani
Prevalence of vitamin D deficiency among Iranian adolescents Abstract Objective: Despite the high prevalence of vitamin D deficiency in adults worldwide, not many studies have evaluated the condition in adolescents. The present study was therefore conducted to assess the prevalence of vitamin D deficiency in a group of students from Shahroud, Iran. Methods: The cross-sectional descriptive analytical study was conducted on junior high and high school students of both genders from urban and rural areas of Shahroud, the largest city of Semnan Province in Iran, in winter 2011. The combination of stratified and cluster random sampling methods was applied in the study. A questionnaire on the demographic data, socioeconomic status, lifestyle habits (sun exposure, physical activity, dairy consumption), and drug and personal history was completed for each student. Blood samples were taken to assess vitamin D levels. Results: One thousand forty-seven students from four junior high and six high schools were recruited. From among them, 42.2% were boys and 57.8% were girls. Mean and standard deviation of vitamin D levels in the studied population were 14.7 ± 9.4 ng/mL. Only 7.2% of the boys and 3.8% of the girls had sensible sun exposure. The median of milk consumption was 3 glasses per week, ranging from 0 to 7.
*Corresponding author: Abbasali Keshtkar, Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Kargar St, Tehran, Iran, Phone/Fax: +98 21 88220072, E-mail: [email protected] Mehdi Ebrahimi, Patricia Khashayar and Zahra Mohammadi: Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Koroush Etemad and Mahboubeh Dini: Non-communicable Disease Department, Ministry of Health and Medical Education, Tehran, Iran Hossein Ebrahimi: School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran Reza Chaman: Community Medicine Department, Shahroud University of Medical Sciences, Shahroud, Iran Bagher Larijani: Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Conclusion: It could be concluded that vitamin D deficiency is quite prevalent among the Iranian adolescents, and this is mainly because this group follows an unhealthy lifestyle due to osteoporosis. Keywords: adolescents; Iran; osteoporosis; vitamin D deficiency. DOI 10.1515/jpem-2013-0428 Received November 5, 2013; accepted April 1, 2014; previously published online May 22, 2014
Introduction Vitamin D, also known as the sunshine vitamin, is well known for its role in bone health (1). This comes while vitamin D deficiency has been identified as a major public health problem worldwide, even in sunny regions (2–4). Vitamin D deficiency is linked with a number of health conditions, the most important of which is osteoporosis. As a result, many have studied the role of vitamin D deficiency in older ages when osteoporosis is more common; less attention, however, has been paid to the role of sunshine vitamin in the building up of peak bone mass in growing children and young adults (5). Moreover, severe vitamin D deficiency in children leads to nutritional rickets and is associated with developmental delays and impaired growth (6). This has been the case despite alarming findings of the poor vitamin D state in young people from many countries. The available studies have confirmed that vitamin D intake has a positive correlation with peak bone mass (7, 8). A systematic review and meta-analysis by Winzenberg et al., however, reported that supplementation with vitamin D is only effective in adolescents with low serum levels of vitamin D (9). Iran, despite being a sunny country, has a high rate of vitamin D deficiency. According to the Iranian Multicentric Study of Osteoporosis (IMOS), moderate to severe vitamin D deficiency is seen in 47.2%, 45.7%, and 44.2% of men aged
Mehdi Ebrahimi, Patricia Khashayar, Abbasali Keshtkar*, Koroush Etemad, Mahboubeh Dini, Zahra Mohammadi, Hossein Ebrahimi, Reza Chaman and Bagher Larijani
Prevalence of vitamin D deficiency among Iranian adolescents Abstract Objective: Despite the high prevalence of vitamin D deficiency in adults worldwide, not many studies have evaluated the condition in adolescents. The present study was therefore conducted to assess the prevalence of vitamin D deficiency in a group of students from Shahroud, Iran. Methods: The cross-sectional descriptive analytical study was conducted on junior high and high school students of both genders from urban and rural areas of Shahroud, the largest city of Semnan Province in Iran, in winter 2011. The combination of stratified and cluster random sampling methods was applied in the study. A questionnaire on the demographic data, socioeconomic status, lifestyle habits (sun exposure, physical activity, dairy consumption), and drug and personal history was completed for each student. Blood samples were taken to assess vitamin D levels. Results: One thousand forty-seven students from four junior high and six high schools were recruited. From among them, 42.2% were boys and 57.8% were girls. Mean and standard deviation of vitamin D levels in the studied population were 14.7 ± 9.4 ng/mL. Only 7.2% of the boys and 3.8% of the girls had sensible sun exposure. The median of milk consumption was 3 glasses per week, ranging from 0 to 7.
*Corresponding author: Abbasali Keshtkar, Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Kargar St, Tehran, Iran, Phone/Fax: +98 21 88220072, E-mail: [email protected] Mehdi Ebrahimi, Patricia Khashayar and Zahra Mohammadi: Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Koroush Etemad and Mahboubeh Dini: Non-communicable Disease Department, Ministry of Health and Medical Education, Tehran, Iran Hossein Ebrahimi: School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran Reza Chaman: Community Medicine Department, Shahroud University of Medical Sciences, Shahroud, Iran Bagher Larijani: Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Conclusion: It could be concluded that vitamin D deficiency is quite prevalent among the Iranian adolescents, and this is mainly because this group follows an unhealthy lifestyle due to osteoporosis. Keywords: adolescents; Iran; osteoporosis; vitamin D deficiency. DOI 10.1515/jpem-2013-0428 Received November 5, 2013; accepted April 1, 2014; previously published online May 22, 2014
Introduction Vitamin D, also known as the sunshine vitamin, is well known for its role in bone health (1). This comes while vitamin D deficiency has been identified as a major public health problem worldwide, even in sunny regions (2–4). Vitamin D deficiency is linked with a number of health conditions, the most important of which is osteoporosis. As a result, many have studied the role of vitamin D deficiency in older ages when osteoporosis is more common; less attention, however, has been paid to the role of sunshine vitamin in the building up of peak bone mass in growing children and young adults (5). Moreover, severe vitamin D deficiency in children leads to nutritional rickets and is associated with developmental delays and impaired growth (6). This has been the case despite alarming findings of the poor vitamin D state in young people from many countries. The available studies have confirmed that vitamin D intake has a positive correlation with peak bone mass (7, 8). A systematic review and meta-analysis by Winzenberg et al., however, reported that supplementation with vitamin D is only effective in adolescents with low serum levels of vitamin D (9). Iran, despite being a sunny country, has a high rate of vitamin D deficiency. According to the Iranian Multicentric Study of Osteoporosis (IMOS), moderate to severe vitamin D deficiency is seen in 47.2%, 45.7%, and 44.2% of men aged
