Hypovitaminosis D in the Middle East and North Africa

Abstract

Background: The Middle East and North Africa (MENA) region registers some of the highest rates of hypovitaminosis D worldwide. Aim: We systematically reviewed the prevalence of hypovitaminosis D, rickets and osteomalacia, their predictors and impact on major outcomes, in the region. Methods: Medline, Pubmed and Embase search engines, entering keywords and concepts, combined with individual countries of interest, were used. Search was limited years 2000–2012; and review articles were used for the period preceding year 2000. Results: Rickets and osteomalacia still occur in this sunny region. Hypovitaminosis D prevails, with rates varying 30–90%, considering a desirable serum 25 hydroxy-vitamin D [25(OH)D] of 20 ng/ml. Advancing age, female gender, multi-parity, clothing style, season, socio-economic status and urban living are recognized predictors of hypovitaminosis D in adults. Prolonged breastfeeding without vitamin D supplementation and low dietary calcium intake are the recognized risk factors for rickets and hypovitaminosis D in children.. Associations with pain score and disease activity in rheumatologic disorders, viral load and interleukins in hepatitis C, BMI, lipids and insulin sensitivity, blood pressure, heart failure and mortality are described. Sun exposure in adults decreased prevalence of metabolic syndrome in one study. Few randomized vitamin D trials revealed that the majority of mothers or children failed to achieve a desirable 25(OH)D level, even with doses by far exceeding current recommendations. A trial in adolescent girls reveals substantial bone and lean mass increments. Conclusion: Hypovitaminosis D is prevalent in MENA. The lack of populations based studies, gaps in studies in infants, pre-pubertal children and pregnant women, hinder the development of region specific guidelines and constitute a major obstacle to impact this chronic and most often subclinical disease.

Vitamin D deficiency among healthy Egyptian females

“…In this systematic review, the few studies retrieved from Egypt were conducted among patients with other diseases, such as systemic lupus erythrematosis (SLE), fibromyalgia and HCV (hepatitis C virus). In the same review, being of the female gender was among the predictors of hypovitaminosis D. 15 Thus, the goal of this study was to check the vitamin D status of healthy adult Egyptian females and determine possible contributing factors affecting the vitamin D status of the study groups.…”

Incidence and Risk Profile of Dementia in the Regions of Middle East and North Africa

“…Varying rates of hypovitaminosis D are reported in most MENA countries although there is only insufficient population-based data to determine reliable estimates on hypovitaminosis D [64]. This dementia risk factor might be particularly relevant among MENA women because of Burqa that might limit their required natural sun exposure.…”

Frequency of diabetes, complications and vascular risk factors in male and female population of Al-Jouf, KSA

“…Likewise, vitamin D deficiency has been consistently associated with hypertension, diabetes mellitus, cardiovascular disease, and stroke [23]. MENA regions in general have a very high prevalence of vitamin D deficiency (<50 nmol/L 25-hydroxyvitamin D), particularly in KSA based on the recent meta-analysis and report of Bassil et al [24][25][26] for the entire MENA region.…”