Prevalence, trend, and predictor analyses of vitamin D deficiency in the US population, 2001–2018

Abstract

BackgroundThe National Health and Nutrition Examination Surveys (NHANES) collect and release data to the public every 2 years. The latest NHANES study on the vitamin D status of Americans was based on data from 2001 to 2014, and the latest data (2015–2016 and 2017–2018) have not been studied yet. Thus, we extracted all the available data from NHANES (2001–2018), aiming to analyze the prevalence and trends of vitamin D deficiency (VDD) in the US population to bridge the research gap.MethodsAccording to previous studies and nutritional guidelines for vitamin D, severe VDD was defined as serum 25(OH)D levels of <25 nmol/L, moderate deficiency as 25–50 nmol/L, insufficiency as 50–75 nmol/L, and sufficiency as >75 nmol/L. We comprehensively estimated the prevalence of serum 25(OH)D levels of <25, 25–50, 50–75, and >75 nmol/L in Americans and described trends in vitamin D status from 2001 to 2018. Weighted multivariate linear regression models were used to explore the predictors of VDD. All analyses and the data were adjusted for the complex sampling design of NHANES using Mobile Examination Center (MEC) weights.ResultsBased on the most recent data of 71,685 participants, our study showed that the weighted prevalence of severe and moderate VDD was 2.6% and 22.0%, and the prevalence of vitamin D insufficiency (VDI) and sufficiency was 40.9% and 34.5%. The prevalence of severe and moderate VDD was higher in women, non-Hispanic black Americans, people aged 20–29 years, and during the season of winter. From 2001 to 2018, we found a slight linear decrease in the prevalence of moderate VDD (coefficient = −0.847; P = 0.009) and VDI (coefficient = −0.810; P = 0.014). We also found a slight linear increase in vitamin D sufficient (coefficient = 1.693; P = 0.004). However, no trend change was observed in severe VDD (coefficient = −0.037; P = 0.698). Age, sex, ethnicity, season, sun-protective behaviors, lower BMI, lower socioeconomic status (SES), drinking, and lower milk consumption were predictors of severe VDD.ConclusionVitamin D deficiency is still prevalent in the United States, especially in non-Hispanic black Americans, women, individuals aged 20–29, and during winter. Therefore, individuals, healthcare providers, and policymakers should take public health measures to develop and implement prevention strategies to deal with VDD.

A role for vitamin D and the vitamin D receptor in keloid disorder

“…Limitations of this study included the relatively low number of participants reported to exhibit excessive scarring, which was identified based on electronic medical records and included patients with a diagnosis of keloid or hypertrophic scarring, and the fact that most of the participants reported White ethnicity, which may make the findings less generalisable to other ethnic groups that display elevated risks for excessive scar formation 95 . Additionally, the rates of vitamin D deficiency in both the excessive scarring group and the unaffected control group (5.1% and 2.4%, respectively) were much lower than rates of vitamin D deficiency in the United States (24.6% for the years 2001–2018), 98 which has a more ethnically diverse population.…”

Optimizing Perioperative Nutrition for Spine Surgery

“…Vitamin D deficiency has become a global issue, especially for individuals whose occupation or lifestyle precludes them from gaining sufficient sun exposure. 21 Vitamin D is a crucial nutrient in maintaining bone quality via maintenance of calcium and phosphorus balance. In spine surgery, older age is a risk factor for decreased bone mineral density leading to osteoporosis and increased risk of degenerative spine disorders.…”

“…10,22 Vitamin D deficiency is defined by the Endocrine Society for Clinical Practice Guideline as a serum concentration <50 nmol/L, whereas a concentration >75 nmol/L is sufficient. 21,23,24 The vitamin D metabolite total 25-hydroxyvitamin D is the most commonly used biomarker in determining serum levels. 25 The goal concentration of serum vitamin D is around 75 nmol/L, but modifications accounting for differences in age, weight, and ethnicity are needed.…”

Role of Vitamin D Deficiency in the Pathogenesis of Cardiovascular and Cerebrovascular Diseases

“…Estimates of the prevalence of VDD ranges from 24% (United States) to 40% (European Union) [ 2 , 3 , 4 , 5 , 6 , 7 , 8 ]. It is now evident that, in addition to the musculoskeletal system, most tissues and cell types express VitD receptors and VitD, in addition to its role in promoting and maintaining skeletal health, confers complex health benefits in multiple organ systems, including the immune system and the cardiovascular system [ 9 , 10 , 11 ].…”