Serum 25-hydroxyvitamin D status, quantitative ultrasound parameters, and their determinants in Greek population
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Vitamin D deficiency and quantitative ultrasound measurements are associated with bone fragility. We assessed these parameters and their correlates. 87.7% of the population has vitamin D inadequacy and this correlated with lifestyle factors. These results contribute to epidemiological data needed for population guidelines for bone health.
Vitamin D deficiency and quantitative ultrasound (QUS) parameters are among the most important clinical risk factors of bone fragility. Few data are available for Greek population. The aim of the study was to evaluate the serum 25-hydroxyvitamin D [25(OH)D] level and their determinants, as well as QUS parameters in Greek population.
OSTEOS is an observational cross-sectional study conducted from June 2010 to July 2012. Nine hundred seventy adults were recruited from rural and urban areas throughout Greece and completed the appropriate questionnaire. Serum 25(OH)D measured by enzyme immunoassay, QUS parameters, broadband ultrasound attenuation (BUA), speed of sound (SOS) and stiffness index (SI), was assessed with an Achilles device. Univariate Analysis of Variance was used for the assessment of serum 25(OH)D determinants.
Mean serum 25(OH)D of the total population was 20,00 ± 8,00 ng/mL. Females had lower levels than males. The negative determinants of serum 25(OH)D in the total population were the female sex and the winter-spring season of sampling while age proved negative association solely in obese subjects. Positive determinants of vitamin D status were summer sun exposure and organized physical activity as expected. Urban had lower SOS and SI than rural residents. Individuals with 25(OH)D ≥ 20 ng/mL had higher SOS than those with 25(OH)D < 20 ng/mL. BUA, SOS, and SI are positively correlated with organized physical activity and negatively with PTH.
This study reports that vitamin D deficiency is highly prevalent among healthy Greek men and women, demonstrates the multifactorial causation of 25(OH)D levels, and points out that further research is required to determine more factors related to vitamin D status and bone health.
KeywordsVitamin D Life-style factors Heel bone properties Epidemiology
The authors thank the Hellenic Society for the Support of Patients with Osteoporosis and all the dietitians and clinicians for their contribution to the project.
Special thanks to post doc researcher Maria Stathopoulou for her contribution to the study design and the dietitian Evangelia Bitsani for the subject recruitment.
This study was partially supported by a research grant from the Hellenic Society for the Study of Bone Metabolism.
Compliance with ethical standards
Conflicts of interest
- 1.Report of a WHO Study Group (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. World Health Organ Tech Rep Ser 843:1–129Google Scholar
- 5.Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Mayne ST, Rosen CJ, Shapses SA (2011) 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 96:53–58CrossRefGoogle Scholar
- 9.Pazaitou-Panayiotou K, Papapetrou PD, Chrisoulidou A, Konstantinidou S, Doumala E, Georgiou E, Panagiotou V, Sotiriadou E, Mavroudi E, Apostolaki-Christopoulou M (2012) Height, whole body surface area, gender, working outdoors, and sunbathing in previous summer are important determinants of serum 25-hydroxyvitamin D levels. Exp Clin Endocrinol Diabetes 120(1):14–22CrossRefGoogle Scholar
- 10.International Physical Activity Questionnaire Available at: http://www.ipaq.ki.se/. Accessed 12 Dec 2009
- 13.World Health Organization (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 894:i–xii 1–253Google Scholar
- 16.Stöckl D, Sluss PM, Thienpont LM (2009) Specifications for trueness and precision of a reference measurement system for serum/plasma 25-hydroxyvitamin D analysis. Clin Chim Acta 408:8–13Google Scholar
- 17.Flöter M, Bittar CK, Zabeu JL, Carneiro AC (2011) Review of comparative studies between bone densitometry and quantitative ultrasound of the calcaneus in osteoporosis. Acta Reumatol Port 36(4):327–335Google Scholar
- 23.Rabenberg M, Scheidt-Nave C, Busch MA, Rieckmann N, Hintzpeter B, Mensink GB (2010) Vitamin D status among adults in Germany--results from the German Health Interview and Examination Survey for Adults (DEGS1). BMC Public Health 15:641. https://doi.org/10.1186/s12889-015-2016-7 CrossRefGoogle Scholar
- 26.Sokolovic S, Alimanovic-Alagic R, Dzananovic L, Cavaljuga S, Beslic N, Ferhatbegovic-Opankovic E (2017) Vitamin D status in Bosnia and Herzegovina: the cross-sectional epidemiological analysis. Osteoporos Int 28(3):1021–1025Google Scholar
- 28.Manios Y, Moschonis G, Lambrinou CP, Mavrogianni C, Tsirigoti L, Hoeller U, Roos FF, Bendik I, Eggersdorfer M, Celis-Morales C, Livingstone KM, Marsaux CF, Macready AL, Fallaize R, O’Donovan CB, Woolhead C, Forster H, Walsh MC, Navas-Carretero S, San-Cristobal R, Kolossa S, Hallmann J, Jarosz M, Surwiłło A, Traczyk I, Drevon CA, van Ommen B, Grimaldi K, Matthews JN, Daniel H, Martinez JA, Lovegrove JA, Gibney ER, Brennan L, Saris WH, Gibney M, Mathers JC, Food4Me Study (2017) Associations of vitamin D status with dietary intakes and physical activity levels among adults from seven European countries: the Food4Me study. Eur J Nutr 57:1357–1368. https://doi.org/10.1007/s00394-017-1415-1 CrossRefPubMedGoogle Scholar
- 29.Greene-Finestone LS, Berger C, de Groh M, Hanley DA, Hidiroglou N, Sarafin K, Poliquin S, Krieger J, Richards JB, Goltzman D, CaMos Research Group (2011) 25-hydroxyvitamin D in Canadian adults: biological, environmental, and behavioral correlates. Osteoporos Int 22(5):1389–1399CrossRefGoogle Scholar
- 37.Moschonis G, Tanagra S, Koutsikas K, Nikolaidou A, Androutsos O, Manios Y (2009) Association between serum 25-hydroxyvitamin D levels and body composition in postmenopausal women: the postmenopausal health study. Menopause 16(4):701–707. https://doi.org/10.1097/gme.0b013e318199d5d5 CrossRefPubMedGoogle Scholar