背景:维生素D缺乏(VDD)通常与阳光照射不足有关。讽刺的是,最近的证据表明,在斯里兰卡等热带地区的城市地区,患病率上升,在没有全面数据的情况下。这项研究旨在评估城市成年人维生素D水平低的患病率及其对血清钙的影响。
方法:对1260名35-74岁的成年人进行了一项基于人群的横断面研究,住在科伦坡,斯里兰卡城市最多的地区。他们来自63个行政区划,使用多级,概率与大小成比例,整群抽样。收集非空腹静脉血,不使用止血带。低维生素D(<30.0ng/mL),用化学发光法测定VDD(<20ng/mL)和维生素D不足(20.0-29.9ng/mL),和血清钙使用钙Gen2试剂。
结果:在人口中(53.3%的女性;平均年龄=51.8岁),低维生素D的患病率为93.9%(95%CI:92.5-95.2).这主要是由于VDD(67.5%;95%CI:64.9.0-70.1%),有一些不足(26.4%;95%CI:24.0-28.9%)。大多数VDD病例(53.9.0%)的严重程度为“轻度”(10.0-<20.0ng/mL),“中度”(12.8%)和“重度”(0.8%)病例较少。女性的VDD患病率最高,35-44岁,生活在“高度城市”地区和泰米尔族。Further,VDD随年龄较大的人群呈下降趋势,虽然女性比男性明显更普遍(72.6%vs.61.7%;p<0.01),在所有年龄组。在9.8%的维生素D低的成年人中观察到低血清钙水平,与正常维生素D的22.4%相比,这意味着可能有维生素D以外的其他因素来维持血清钙水平。
结论:科伦坡区,代表斯里兰卡的城市环境面临着低维生素D的高患病率,主要是VDD,女性发病率较高,年轻人和高度城市地区。这些发现挑战了热带地区保证最佳维生素D水平的假设;并强调了国家维生素D补充和食品强化计划的必要性。特别是在斯里兰卡等南亚国家的高风险城市环境中。
BACKGROUND: Vitamin D deficiency (VDD) is conventionally associated with inadequate sunlight exposure. Ironically, recent evidence suggests a rising prevalence in
urban areas of tropical regions like Sri Lanka, where comprehensive data are unavailable. This study aimed to estimate the prevalence of low vitamin D status in
urban adults and its impact on serum calcium.
METHODS: A population-based cross-sectional study was conducted among 1260 adults aged 35-74 years, living in Colombo, the most
urban district in Sri Lanka. They were recruited from 63 administrative divisions, using multi-stage, probability-proportionate-to-size, cluster sampling. Non-fasting venous blood was collected without tourniquet. Low vitamin D (< 30.0 ng/mL), VDD (< 20 ng/mL) and vitamin D insufficiency (20.0-29.9 ng/mL) were determined using chemiluminescence assay method, and serum calcium using Calcium Gen2 reagent.
RESULTS: Among the population (53.3% females; mean age = 51.8 years), the prevalence of low vitamin D was 93.9% (95% CI: 92.5-95.2). This was primarily due to VDD (67.5%; 95% CI: 64.9.0-70.1%), with some insufficiency (26.4%; 95% CI: 24.0-28.9%). Most VDD cases (53.9.0%) were \'mild\' (10.0- < 20.0 ng/mL) in severity, with fewer \'moderate\' (12.8%) and \'severe\' (0.8%) cases. Prevalence of VDD was highest in females, aged 35-44-years, living in \'highly
urban\' areas and of Tamil ethnicity. Further, VDD showed a decreasing trend with older age groups, while it was significantly more prevalent in females than males (72.6% vs. 61.7%; p < 0.01), across all age groups. Low serum calcium levels were observed in 9.8% of adults with low vitamin D, compared to 22.4% with normal vitamin D, implying that there could be factors other than vitamin D in maintaining serum calcium levels.
CONCLUSIONS: Colombo District, representing urban settings in Sri Lanka faces a high prevalence of low vitamin D, primarily VDD, with higher rates in females, younger individuals and highly
urban areas. These findings challenge assumptions about tropical regions being guaranteed of optimal vitamin D levels; and underscore the need for national vitamin D supplementation and food fortification programs, especially in high-risk urban settings in South Asian countries like Sri Lanka.