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Minerals, trace elements, Vit. D and bone health

Winter 25-hydroxyvitamin D levels in young urban adults are affected by smoking, body mass index and educational level

European Journal of Clinical Nutrition volume 69, pages 355–360 (2015)Cite this article

Subjects

Abstract

Background/objectives:

To study the relationship of winter 25-hydroxycholecalciferol (25-OHD) levels with age, education, place of residency, marital status and body mass index (BMI) as they may affect sun exposure, vitamin D synthesis and metabolism.

Subjects/methods:

Subjects (1952) answered a structured questionnaire concerning education, marital status and smoking; and body weight/height, and parathyroid hormone and 25-OHD were measured.

Results:

25-OHD levels were higher in the males with elementary and secondary education compared with higher education (46.8±18.5 and 43.7±16 vs 39.9±15.3 nmol/l, P<0.01). Vitamin D deficiency was more prevalent (16.7%, (13.1–20.2) vs 10.8%, (8.4–13.2), P=0.08) and sufficiency was less prevalent (24.6% (20–29.2) vs 33.7%, (29.5–37.8), P=0.005) in those with higher than secondary education. No differences were found among the females. Male smokers had lower 25-OHD than nonsmokers (40.2±16.6 vs 43.6±15.7 nmol/l, P=0.004). Deficiency was more prevalent in the male smokers than nonsmokers with secondary and higher education (secondary 16.6%, (10.1–22.4) vs 8.2%, (5.1–11.3), P=0.006; higher 27.4%, (17.7–37.1) vs 13.2%, (9.0–17.5), P=0.003). 25-OHD was lower in the obese than in the normal-weight females (34.6±16.2 vs 38.2±17.8 nmol/l, analysis of variance, P=0.014), but not males. Marital status was not related to 25-OHD. Only in the urban residents, increasing BMI in the young females increased the risk for vitamin D deficiency by 1%, and smoking had an odds ratio of 1.99 (1.05–3.78) in the young and 2.5 (1.07–5.75) in the middle-aged males.

Conclusions:

Smoking and higher education in the males and obesity in the females were factors for vitamin D deficiency among Bulgarian urban population.

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References

  1. Van Schoor NM, Lips P . Worldwide vitamin D status. Best Pract Res Clin Endocrinol Metab 2011; 25: 671–680.

    Article  CAS  Google Scholar 

  2. Semba RD, Houston DK, Bandinelli S, Sun K, Cherubini A, Cappola AR et al. Relationship of 25-hydroxyvitamin D with all-cause and cardiovascular disease mortality in older community-dwelling adults. Eur J Clin Nutr 2010; 64: 203–209.

    Article  CAS  Google Scholar 

  3. Schierbeck LL, Rejnmark L, Tofteng CL, Stilgren L, Eiken P, Mosekilde L et al. Vitamin D deficiency in postmenopausal, healthy women predicts increased cardiovascular events: a 16-year follow-up study. Eur J Endocrinol 2012; 167: 553–560.

    Article  CAS  Google Scholar 

  4. Welsh J . Vitamin D and cancer: integration of cellular biology, molecular mechanisms and animal models. Scand J Clin Lab Invest Suppl 2012; 243: 103–111.

    PubMed  Google Scholar 

  5. Hewison M . Vitamin D and immune function: autocrine, paracrine or endocrine? Scand J Clin Lab Invest Suppl 2012; 243: 92–102.

    PubMed  Google Scholar 

  6. Bogh MKB . Vitamin D production after UVB: aspects of UV-related and personal factors. Scand J Clin Lab Invest Suppl 2012; 243: 24–31.

    PubMed  Google Scholar 

  7. Tsiaras WG, Weinstock MA . Factors influencing vitamin D status. Acta Derm Venereol 2011; 91: 115–124.

    Article  Google Scholar 

  8. Chan J, Jaceldo-Siegl K, Fraser GE . Determinants of serum 25 hydroxyvitamin D levels in a nationwide cohort of blacks and non-Hispanic whites. Cancer Causes Control 2010; 21: 501–511.

    Article  Google Scholar 

  9. Grant WB . Role of solar UV irradiance and smoking in cancer as inferred from cancer incidence rates by occupation in Nordic countries. Dermatoendocrinol 2012; 4: 203–211.

    Article  Google Scholar 

  10. Borissova AM, Shinkov A, Vlahov J, Dakovska L, Todorov T, Svinarov D et al. Vitamin D status in Bulgaria—winter data. Arch Osteoporos 2013; 8: 133–138.

    Article  Google Scholar 

  11. Bischoff-Ferrari H a. ‘Vitamin D - why does it matter?’ - defining vitamin D deficiency and its prevalence. Scand J Clin Lab Invest Suppl 2012; 243: 3–6.

    PubMed  Google Scholar 

  12. Ross a C, Manson JE, Abrams S a, Aloia JF, Brannon PM, Clinton SK et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab 2011; 96: 53–58.

    Article  Google Scholar 

  13. Borissova A-M, Shinkov A, Vlahov J, Dakovska L, Todorov T, Svinarov D et al. Determination of the optimal level of 25(OH)D in the Bulgarian population. Endokrinologya 2012; 17: 135–142.

    Google Scholar 

  14. FDA. Guidance for Industry Bioanalytical Method Validation. Rockville2001.

  15. Souberbielle JC, Courbebaisse M, Cormier C, Pierrot-Deseilligny C, Viard JP, Jean G et al. When should we measure vitamin D concentration in clinical practice? Scand J Clin Lab Invest Suppl 2012; 243: 129–135.

    PubMed  Google Scholar 

  16. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2011; 96: 1911–1930.

    Article  CAS  Google Scholar 

  17. Pludowski P, Karczmarewicz E, Bayer M, Carter G, Chlebna-Sokół D, Czech-Kowalska J et al. Practical guidelines for the supplementation of vitamin D and the treatment of deficits in Central Europe - recommended vitamin D intakes in the general population and groups at risk of vitamin D deficiency. Endokrynol Pol 2013; 64: 319–327.

    Article  CAS  Google Scholar 

  18. Larose TL, Chen Y, Camargo CA, Langhammer A, Romundstad P, Mai XM . Factors associated with vitamin D deficiency in a Norwegian population: the HUNT Study. J Epidemiol Community Health 2014; 68: 165–170.

    Article  Google Scholar 

  19. Hadjinikolova L, Hubenova T, Zaikov A . Status and development tendencies of freshwater aquaculture production in Bulgaria. Bulg J Agric Sci 2010; 16: 398–405.

    Google Scholar 

  20. Park S, Lee BK . Vitamin D deficiency is an independent risk factor for cardiovascular disease in Koreans aged ≥50 years: results from the Korean National Health and Nutrition Examination Survey. Nutr Res Pract 2012; 6: 162–168.

    Article  CAS  Google Scholar 

  21. Looker AC, Pfeiffer CM, Lacher DA, Schleicher RL, Picciano MF . Serum 25-hydroxyvitamin D status of the US population : 1988–1994 compared with 2000–2004 1–3. Am J Clin Nutr 2008; 88: 1519–1527.

    Article  CAS  Google Scholar 

  22. Daly R, Gagnon C, Lu Z, Magliano D, Dunstan D, Sikaris K et al. Prevalence of vitamin D deficiency and its determinants in Australian adults aged 25 years and older: a national, population-based study. Clin Endocrinol (Oxf) 2012; 77: 26–35.

    Article  Google Scholar 

  23. Genzen JR, Gosselin JT, Wilson TC, Racila E, Krasowski MD . Analysis of vitamin D status at two academic medical centers and a national reference laboratory: result patterns vary by age, gender, season, and patient location. BMC Endocr Disord 2013; 13: 52.

    Article  Google Scholar 

  24. Greene-Finestone LS, Berger C, de Groh M, Hanley DA, Hidiroglou N, Sarafin K et al. 25-Hydroxyvitamin D in Canadian adults: biological, environmental, and behavioral correlates. Osteoporos Int 2011; 22: 1389–1399.

    Article  CAS  Google Scholar 

  25. McCullough ML, Weinstein SJ, Freedman DM, Helzlsouer K, Flanders WD, Koenig K et al. Correlates of circulating 25-hydroxyvitamin D: Cohort Consortium Vitamin D Pooling Project of Rarer Cancers. Am J Epidemiol 2010; 172: 21–35.

    Article  Google Scholar 

  26. Hypponen E, Power C . Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors. Am J Clin Nutr 2007; 85: 860–868.

    Article  CAS  Google Scholar 

  27. Shirazi L, Almquist M, Malm J, Wirfält E, Manjer J . Determinants of serum levels of vitamin D: a study of life-style, menopausal status, dietary intake, serum calcium, and PTH. BMC Womens Health 2013; 13: 33.

    Article  Google Scholar 

  28. Tepper S, Shahar DR, Geva D, Ish-Shalom S . Predictors of serum 25(Oh)D increase following bimonthly supplementation with 100,000IU vitamin D in healthy, men aged 25-65 years. J Steroid Biochem Mol Biol 2013; e-pub ahead of print 12 December 2013; doi:10.1016/j.jsbmb.2013.12.005.

  29. Drincic AT, Armas L a G, Van Diest EE, Heaney RP . Volumetric dilution, rather than sequestration best explains the low vitamin D status of obesity. Obesity (Silver Spring) 2012; 20: 1444–1448.

    Article  CAS  Google Scholar 

  30. Kull M, Kallikorm R, Lember M . Body mass index determines sunbathing habits: implications on vitamin D levels. Intern Med J 2009; 39: 256–258.

    Article  CAS  Google Scholar 

  31. Metheniti D, Sakka S, Dracopoulou M, Margeli A, Papassotiriou I, Kanaka-Gantenbein C et al. Decreased circulating 25-(OH) vitamin D concentrations in obese female children and adolescents: positive associations with retinol binding protein-4 and neutrophil gelatinase-associated lipocalin. Hormones (Athens) 2013; 12: 397–404.

    Article  Google Scholar 

  32. González-Molero I, Rojo-Martínez G, Morcillo S, Gutierrez C, Rubio E, Pérez-Valero V et al. Hypovitaminosis D and incidence of obesity: a prospective study. Eur J Clin Nutr 2013; 67: 680–682.

    Article  Google Scholar 

  33. Barchetta I, De Bernardinis M, Capoccia D, Baroni MG, Fontana M, Fraioli A et al. Hypovitaminosis D is independently associated with metabolic syndrome in obese patients. PLoS One 2013; 8: e68689.

    Article  CAS  Google Scholar 

  34. Earthman CP, Beckman LM, Masodkar K, Sibley SD . The link between obesity and low circulating 25-hydroxyvitamin D concentrations: considerations and implications. Int J Obes 2012; 36: 387–396.

    Article  CAS  Google Scholar 

  35. Wamberg L, Christiansen T, Paulsen SK, Fisker S, Rask P, Rejnmark L et al. Expression of vitamin D-metabolizing enzymes in human adipose tissue-the effect of obesity and diet-induced weight loss. Int J Obes 2013; 37: 651–657.

    Article  CAS  Google Scholar 

  36. Wong KE, Kong J, Zhang W, Szeto FL, Ye H, Deb DK et al. Targeted expression of human vitamin D receptor in adipocytes decreases energy expenditure and induces obesity in mice. J Biol Chem 2011; 286: 33804–33810.

    Article  CAS  Google Scholar 

  37. Soldin OP, Makambi KH, Soldin SJ, O’Mara DM . Steroid hormone levels associated with passive and active smoking. Steroids 2011; 76: 653–659.

    Article  CAS  Google Scholar 

  38. Szulc P, Garnero P, Claustrat B, Marchand F, Duboeuf F, Delmas PD . Increased bone resorption in moderate smokers with low body weight: The Minos Study. J Clin Endocrinol Metab. Endocri Soc 2002; 87: 666–674.

    Article  CAS  Google Scholar 

  39. Supervía A, Nogués X, Enjuanes A, Vila J, Mellibovsky L, Serrano S et al. Effect of smoking and smoking cessation on bone mass, bone remodeling, vitamin D, PTH and sex hormones. J Musculoskelet Neuronal Interact 2006; 6: 234–241.

    PubMed  Google Scholar 

  40. Borissova A-M, Shinkov A, Vlahov J, Dakovska L, Todorov T, Svinarov D et al. Comparative analisis on distribution of deficiency and insufficiency of vitamin D in diferent types living places in Bulgaria. Endokrinologya 2013; 17: 143–157.

    Google Scholar 

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Acknowledgements

The study has been supported by the Bulgarian Society of Endocrinology to the best knowledge of the authors.

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Authors and Affiliations

  1. Department of Thyroid and Bone Mineral Diseases, University Hospital of Endocrinology, Medical University of Sofia, Sofia, Bulgaria

    A Shinkov, A-M Borissova, L Dakovska & J Vlahov

  2. Central Laboratory of Therapeutic Drug Management and Clinical Pharmacology, Alexander University Hospital, Medical University of Sofia, Sofia, Bulgaria

    L Kassabova & D Svinarov

Authors
  1. A Shinkov
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  2. A-M Borissova
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  3. L Dakovska
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  4. J Vlahov
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Correspondence to A Shinkov.

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Shinkov, A., Borissova, AM., Dakovska, L. et al. Winter 25-hydroxyvitamin D levels in young urban adults are affected by smoking, body mass index and educational level. Eur J Clin Nutr 69, 355–360 (2015). https://doi.org/10.1038/ejcn.2014.163

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