Academic journal article Central European Journal of Public Health

Vitamin D Status and Health Correlates among Apparently Healthy Participants in an Urban, Sunny Region

Academic journal article Central European Journal of Public Health

Vitamin D Status and Health Correlates among Apparently Healthy Participants in an Urban, Sunny Region

Article excerpt


Aim: To assess vitamin D status and health correlates in a sample of apparently healthy Caucasian participants residing in an urban area, Athens, with latitude 370 58' 0'' N and longitude 230 43' 0''E, after taking into consideration a broad range of purported biological, behavioural and environmental factors.

Method: Men and women 35+ years from a selected population (n=490) were studied. Participants completed a detailed questionnaire regarding socio-demographic, lifestyle, clinical and dietary characteristics. Biomarkers were measured after 12 h fasting. Linear and multinomial regression models were used to evaluate the association between 25(OH)D and determinants of vitamin D status.

Results: Results revealed that one hour increase of sunlight exposure decreased the odds of having D deficiency (i.e., <20 ng/mL) by 70% (OR=0.30, 95% CI: 0.20-0.45), adjusted forage, sex, family status, physical activity, smoking habits, BMI, triglycerides, parathyroid hormone, uric acid, haptoglobin, folate acid and haemoglobin, as compared to sufficient levels (i.e., >30 ng/mL). Regarding biomarkers, parathyroid hormone and haptoglobin were found to be related with the odds of having vitamin D deficiency (OR=1.11, 95% CI: 1.05-1.16; OR=1.02, 95% CI: 1.00-1.03, respectively) as compared to the sufficient levels.

Conclusions: Sufficient serum vitamin D levels were observed among participants with characteristics associated with reduced cardiovascular risk, such as normal BMI, increased physical activity, decreased parathyroid hormone and decreased inflammatory markers. Even a slight increase in sunlight exposure could have beneficial effects on serum vitamin D concentrations and eventually on haemoglobin and inflammatory markers levels, thus providing a simple and inexpensive lifestyle intervention that promotes public health.

Key words: vitamin D, sunshine, inflammation, cardiovascular risk, haemoglobin


Vitamin D has two forms, vitamin D2 and vitamin D3, also called ergocalciferol and cholecalciferol, respectively. Vitamin D3 is produced in the skin in response to ultraviolet B radiation from sunlight or can be obtained from the diet (i.e., animal sources such as deep sea fatty fish, egg yolks, or liver) or from supplements. Both forms of vitamin D are converted to 25-hydroxyvitamin D [25(OH)D] in the liver, and the serum levels of 25(OH)D are measured to determine vitamin D status. Serum 25(OH)D is considered the best functional indicator of vitamin D status reflecting the sum of cutaneous synthesis and oral intake (1).

There is a critical requirement of vitamin D for bone and mineral homeostasis, and in particular in preventing rickets and osteomalacia. Inadequate vitamin D blood level has been implicated in increased risk for osteoporosis, cardiovascular disease, diabetes, cancer and autoimmune diseases such as multiple sclerosis (2-5). However, the blood levels of 25(OH)D that define vitamin D deficiency remain somewhat controversial. Currently, most agree that vitamin D concentration below 20 ng/ml indicates vitamin D deficiency, whereas a concentration of 2 1-29 ng/ml is considered insufficient, and a 25(OH)D level of 30-100 ng/ml defines vitamin D sufficiency (6).

Vitamin D deficiency is currently considered an important public health problem. It has been estimated that 1 billion people worldwide suffer from vitamin D deficiency (7). Children and adolescents are also potentially at high risk for vitamin D deficiency, especially at high latitudes at the end of the winter. Unfortunately, very few foods naturally contain vitamin D, and even fewer are fortified. Besides, above 37° latitude during the winter months very little if any vitamin D3 is produced in the skin. These are some of the main reasons why vitamin D deficiency has become epidemic for all age groups in the United States and Europe (8). In fact, no one is immune from vitamin D deficiency.

Up to date, data regarding Caucasian populations are limited and there is a concern regarding the potential role of vitamin D deficiency in the Mediterranean region and especially in the Greek population. …

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