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Global vitamin D status and determinants of hypovitaminosis D
Authors:A Mithal  D A Wahl  J-P Bonjour  P Burckhardt  B Dawson-Hughes  J A Eisman  G El-Hajj Fuleihan  R G Josse  P Lips  J Morales-Torres
Institution:1. Indraprastha Apollo Hospitals, Sarita Vihar, Delhi-Mathura Road,, 110044, New Delhi, India
2. International Osteoporosis Foundation, 9, Rue Juste Olivier, 1203, Nyon, Switzerland
4. Division of Bone Diseases, Geneva Hospitals and Faculty of Medicine, Rue Micheli-du-Crest 24, 1211, Geneva, Switzerland
5. Association Suisse contre l’Ostéoporose, Clinique Bois-Cerf, Avenue d’Ouchy 31, 1006, Lausanne, Switzerland
3. Department of Agriculture Human Nutrition, Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, 02111, USA
6. Garvan Institute of Medical Research, St Vincent’s Hospital and University of New South Wales, 384 Victoria Street, Sydney, NSW 2010, Australia
7. Department of Internal Medicine, American University of Beirut Medical Center, P.O. Box?11-0236, Riad El Solh, 4407 2020, Beirut, Lebanon
8. St Michael’s Hospital Health Centre, 61 Queen Street East, 6th Floor, Suite 6122, Toronto, ON, M5C 2T2, Canada
9. Division of Internal Medicine, Endocrine Section, VU University Medical Center, P.O. Box?7057, 1007 MB, Amsterdam, The Netherlands
10. Hospital Aranda de la Parra, Hidalgo 329-704, León, 37000, GTO, Mexico
Abstract:

Summary

This review describes the vitamin D status in different regions of the world with the objective of understanding the scope of hypovitaminosis D and the factors related to its prevalence that may contribute to the pathogenesis of osteoporosis and fragility fractures.

Introduction

Vitamin D status has been linked to the pathogenesis of hip fractures as well as other skeletal and non-skeletal disorders. The purpose of this review is to provide a global perspective of vitamin D status across different regions of the world and to identify the common and significant determinants of hypovitaminosis D.

Methods

Six regions of the world were reviewed—Asia, Europe, Middle East and Africa, Latin America, North America, and Oceania—through a survey of published literature.

Results

The definition of vitamin D insufficiency and deficiency, as well as assay methodology for 25-hydroxyvitamin D or 25(OH)D, vary between studies. However, serum 25(OH)D levels below 75 nmol/L are prevalent in every region studied whilst levels below 25 nmol/L are most common in regions such as South Asia and the Middle East. Older age, female sex, higher latitude, winter season, darker skin pigmentation, less sunlight exposure, dietary habits, and absence of vitamin D fortification are the main factors that are significantly associated with lower 25(OH)D levels.

Conclusion

Reports from across the world indicate that hypovitaminosis D is widespread and is re-emerging as a major health problem globally.
Keywords:
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