A High Prevalence of Vitamin D Deficiency Observed in an Irish South East Asian Population: A Cross-Sectional Observation Study

Abstract

At northern latitudes, non-ethnic population groups can be at an increased risk of vitamin D deficiency (defined as a 25-hydroxyvitamin D [25(OH)D] status ≤30 nmol/L). The vitamin D status of ethnic minority groups has been examined both in UK and European populations, but not in the Irish context. The aim of this study is to assess the vitamin D status from a selection of the Dublin population of South East Asian descent. A search was conducted, using the laboratory information system of St James’s Hospital, Dublin, for vitamin D requests by General practitioners. From 2013 to 2016, 186 participants were identified and 25(OH)D analysis was quantified using liquid chromatography-tandem mass spectrometry (LC-MS-MS). Overall, the median age was 32 years, 51% were male, and the 25(OH)D concentration ranged from 10 to 154 nmol/L. In total, 66.7% of the total sample were vitamin D deficient and 6.7% had a 25(OH)D status greater than 50 nmol/L (the 25(OH)D concentration defined by the EU as ‘sufficient’). Females had a significantly higher 25(OH)D concentration than males (25.0 vs. 18.0 nmol/L; p = 0.001) but both groups had a significant proportion with deficient status (56% and 76.8%, respectively). Seasonal variation of 25(OH)D was not evident while high rates of deficiency were also observed in those aged <18 years and >50 years. Given the importance of vitamin D for health, this sub-population could be at a significantly increased risk of rickets, impaired bone metabolism, and osteoporosis. In addition, vitamin D deficiency has been associated with several non-bone related conditions, including cardiovascular disease and diabetes. Currently, there is no unique vitamin D intake or vitamin D status maintenance guidelines recommended for adults of non-Irish descent; this needs to be considered by the relevant public health bodies in Ireland.

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“…This cohort also has a wide range of vitamin D levels recorded, with one-third of patients demonstrating vitamin D insufficiency or deficiency. Vitamin D insufficiency was more common in non-white participants, which has previously been reported in Irish populations [51]. We noted an association between female sex and reduced distance covered for the 6MWT, which is well recognised within healthy populations [52].…”

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“…The lower vitamin D concentration was not only observed in the population living in South East Asia but also of its descent who live in Europe (mean = 22.1 ng/ml and 22.8 ng/ml, respectively). This suggests an influence of genetic variance on vitamin D metabolism that warrants further investigation [38,39]. Aside from the difference in skin tone, the higher visceral adipose tissue (VAT) in South Asian compared to European descent is associated with higher sequestration and therefore lower vitamin D concentration [40].…”