Description
Introduction
Vitamin D is essential for a variety of processes in the body and deficiency is a significant risk factor for a multitude of diseases (osteoporosis, inflammatory, metabolic, cardiovascular, neurodegenerative, and cancer) (1,2). The prevalence of vitamin D insufficiency is high. Studies have shown that a significant percentage of the global population has inadequate vitamin D levels, even populations living in warm, sunny climates (3,4). Insufficiency and even deficiency was detected in both adults and children worldwide (5).
In this study, we determined vitamin D levels and the prevalence of vitamin D insufficiency, deficiency, or hypervitaminosis in the Czech population 2011–2019. Furthermore, we examined the correlations of vitamin D levels with the month of the year, the prevalence of influenza, and homocysteine.
Methodology
The study was carried out in Hradec Kralove, the Czech Republic. A total of 119,925 individuals aged 0–100 years were enrolled.
Vitamin D and homocysteine levels
Vitamin D and homocysteine were detected in serum from peripheral blood by Alinityi 25-OH Vitamin D Reagent Kit (Abott; Ireland) and IMMULITE®2000 Homocysteine (Siemens Healthcare Diagnostics; Germany).
Vitamin D status
Vitamin D status (Endocrine Society's clinical practice guidelines; 6):
● Sufficiency: ≥ 75 nmol/L
● Insufficiency: 50 to <75 nmol/L
● Deficiency <50 nmol/L
● Hypervitaminosis: >250 nmol/L
Sunlight (hours per month)
Average value of sunshine in hours per month recorded in 2013-2022 in Klementinum (weather station) https://www.chmi.cz/historicka-data/pocasi/mesicni-data/mesicni-data-dle-z.-123-1998-Sb#
Flu prevalence
Data on the percentage of flu positive samples were obtained on http://atlas.ecdc.europa.eu/public/index.aspx
Results
Vitamin D levels
Vitamin D levels differ according to age. The highest were in infants aged 0 to 1 years (median: 86.60 nmol/L). The lowest in the oldest participants (median: 48.75 nmol/L). In all participants, males had lower vitamin D levels compared to females (p<0.001).
Vitamin D status
The lowest vitamin deficiency and insufficiency was in infants. 65.6% of infants had sufficient vitamin D levels. Only 8% were vitamin D deficient. The highest prevalence of deficiency was in the 91–100 group (51.8% vs. sufficient levels 25.6%). The lowest prevalence of sufficiency was in the 6–15 group (19.2%), the prevalence of insufficiency and deficiency was 42.5% and 38.3%, respectively. In all age groups, except infants and preschool children, the prevalence of deficiency was > 30%. Hypervitaminosis was very rare.
Correlations
Strong correlation between vitamin D and age, month of the year, sunlight, and flu positivity was detected. A linear mixed model revealed that vitamin D levels are strongly affected by age, sunlight, and homocysteine levels.
Conclusion
Data show that the prevalence of vitamin D insufficiency and deficiency is high. Data can be use for prevention purposes, to evaluate whether vitamin D levels in the population need to be monitored, and to recommend supplementation to reduce morbidity in the population.
Acknowledgements
The study was supported by Charles University, Faculty of Medicine in Hradec Kralove, the Czech Republic, by project SVV-260543/2020 and by the Cooperatio Program, research area HEAS.
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