Determinants of Circulating 25-Hydroxyvitamin D and bone Mineral Density in Young Physicians

Manickam, Buvana; Washington, Terri; Villagrana, Nancy E.; Benjamin, Aaron S.; Kukreja, Subhash C.; Barengolts, Elena

doi:10.4158/ep11269.or

Cited by 9 publications

(9 citation statements)

References 34 publications

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“…Underground miners50Zonguldak, Turkey (41°45′N)Cross-sectional24.5 ± 28.22. Surface workers5035.3 ± 29.3Healthcare StudentsMaeda (2007) [108]Medical students44Sao Paulo (23° 34′S), BrazilDescriptive81.5 ± 35.8Gonzalez-Padilla (2011) [117]Medical students103Gran Canaria, Canary Islands (27°92′N)Descriptive69.6 ± 31.0<75 nmol/L: 28.6%<50 nmol/L: 32.6%Paper reported unit as ng/dL but ng/ml was used for calculationKaehler (2012) [118]Female healthcare professional students215Innsbruck, Austria (47°27′N)Cross-sectional50.3 ± 16.6<75 nmol/L: 33.5%<50 nmol/L: 55.8%Al-Elq (2012) [119]Medical students198Dammam, Saudi Arabia (26°39′N)Cross-sectional21.2 ± 11.9<75 nmol/L: 4%<50 nmol/L: 96%Manickam (2012) [120]Medical students and residents104Chicago, IL, USA (42°N)Descriptive54.0 ± 28.0<75 nmol/L: 77%Zabihiyeganeh (2014) [121]Medical students100Tehran, Iran (35° 69′N)Cross-sectional42.0 ± 11.7<75 nmol/L: 15%<50 nmol/L: 84%Milovanovic (2015) [122]Medical, pharmacy and dental students86Kragujevac, Serbia (44°N)Descriptive33.1 ± 12.1<50 nmol/L: 88.4%Medical ResidentsHaney (2004) [61]Medical residents34Portland, OR, USA (45°52′ N)Interrupted series56.4 ± 20.1<50 nmol/L: 38%Paper reported unit as ng/dL but ng/ml was used for calculationMaeda (2007) [108]Medical residents49Sao Paulo, Brazil (23° 34′S)Descriptive67.1 ± 27.0Orlandin Premaor (2014) [123]Medical residents73Porto Alegre, Brazil (30°S)Cross-sectional44.7 ± 20.0<50 nmol/L: 57.4%…”

Section: Resultsmentioning

confidence: 99%

Vitamin D levels and deficiency with different occupations: a systematic review

et al. 2017

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BackgroundVitamin D deficiency is prevalent worldwide, but some groups are at greater risk. We aim to evaluate vitamin D levels in different occupations and identify groups vulnerable to vitamin D deficiency.MethodsAn electronic search conducted in Medline, Embase, the Cochrane Central Register of Controlled Trials, and CINAHL Plus with Full Text generated 2505 hits; 71 peer-reviewed articles fulfilled the inclusion criteria. Occupations investigated included outdoor and indoor workers, shiftworkers, lead/smelter workers, coalminers, and healthcare professionals. We calculated the pooled average metabolite level as mean ± SD; deficiency/insufficiency status was described as % of the total number of subjects in a given category.ResultsCompared to outdoor workers, indoor workers had lower 25-hydroxyvitamin D (25-(OH)D) levels (40.6 ± 13.3 vs. 66.7 ± 16.7 nmol/L; p < 0.0001). Mean 25-(OH)D levels (in nmol/L) in shiftworkers, lead/smelter workers and coalminers were 33.8 ± 10.0, 77.8 ± 5.4 and 56.6 ± 28.4, respectively. Vitamin D deficiency (25-(OH)D < 50 nmol/L), was high in shiftworkers (80%) and indoor workers (78%) compared to outdoor workers (48%). Among healthcare professionals, medical residents and healthcare students had the lowest levels of mean 25-(OH)D, 44.0 ± 8.3 nmol/L and 45.2 ± 5.5 nmol/L, respectively. The mean 25-(OH)D level of practising physicians, 55.0 ± 5.8 nmol/L, was significantly different from both medical residents (p < 0.0001) and healthcare students (p < 0.0001). Nurses and other healthcare employees had 25-(OH)D levels of 63.4 ± 4.2 nmol/L and 63.0 ± 11.0 nmol/L, respectively, which differed significantly compared to practising physicians (p = 0.01), medical residents (p < 0.0001) and healthcare students (p < 0.0001).Rates of vitamin D deficiency among healthcare professionals were: healthcare students 72%, medical residents 65%, practising physicians 46%, other healthcare employees 44%, and nurses 43%. Combined rates of vitamin D deficiency or insufficiency (25-(OH)D < 75 nmol/L) were very high in all investigated groups.Potential confounders such as gender and body composition were not consistently reported in the primary studies and were therefore not analyzed. Furthermore, the descriptions of occupational characteristics may be incomplete. These are limitations of our systematic review.ConclusionsOur review demonstrates that shiftworkers, healthcare workers and indoor workers are at high risk to develop vitamin D deficiency, which may reflect key lifestyle differences (e.g. sunlight exposure). This may help target health promotion and preventive efforts.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4436-z) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Vitamin D levels and deficiency with different occupations: a systematic review

et al. 2017

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“…These conflicting results could be due to various reasons . One study in Chicago measured the serum 25OHD levels and BMD in 104 young physicians and found that vitamin D insufficiency and a low BMD could be important contributors to future osteoporotic fractures . The present study showed that low serum 25OHD levels were associated with low BMD and high disease activity in RA.…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 36% of healthy young adults and up to 57% of general medicine inpatients in the USA suffer from vitamin D inadequacy. These figures are even higher in Europe . According to reports that have been published in China since 2000, vitamin D deficiency and insufficiency were widespread and prevalent.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D deficiency and low bone mineral density in native Chinese rheumatoid arthritis patients

Chen

Lin

et al. 2013

Int J Rheum Dis

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“…Serum 25(OH)D was measured by a direct, competitive- type chemiluminescence immunoassay (CLIA) original assay (Liaison, DiaSorin, Stillwater, MN, USA) (21,22). The intra- and inter-assay coefficients of variability (CVs) were 10.8% and 13.9%, respectively.…”

Section: Methodsmentioning

confidence: 99%

Relationship Between Glycated Hemoglobin and Circulating 25-Hydroxyvitamin D Concentration In African American And Caucasian American Men

et al. 2013

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Objectives To examine whether (1) serum 25-hydroxy-vitamin D level (25[OH]D) is a risk factor for hyperglycemia, as assessed by glycated hemoglobin (HbA1c), in African American men (AAM) and (2) 25(OH)D is a predictor of HbA1c in AAM and Caucasian American men (CAM). Methods We prospectively assessed 25(OH)D and HbA1c in 1,074 men, outpatients with and without diabetes, at an urban Veteran Administration Medical Center (66.8% AAM, 26.4% CAM, 6% Hispanic, 0.4% Asian, and 0.4% Native American men). Multivariate regression analyzed the determinants of HbA1c after accounting for potential confounders. Results We found high prevalence of low (< 30 ng/mL) 25(OH)D (81%) and elevated (≥5.7%) HbA1c (53.5%). The 25(OH)D was inversely associated with HbA1c in all men (r = −0.12, P<.001), in AAM (r = −0.11, P = .003), and in CAM (r = −0.15, P = .01). In the entire group the independent determinants of HbA1c included body mass index (BMI), age, 25(OH)D levels, systolic blood pressure (BP), triglycerides, high-density lipoprotein (HDL), and current alcohol use (P<.0001, .013, .009, .01, .008, .034, and .048, respectively) while glomerular filtration rate (GFR) and marital status showed borderline significance (P = .08 and .09, respectively). In AAM these determinants included BMI, 25(OH)D levels, systolic BP, and current alcohol use (P<.0001, .01, .02, and .03, respectively), while age had borderline significance (P = .06). In CAM, these included BMI, age, and triglycerides (P = .01, .03, and .004, respectively) but not 25(OH)D levels (P = .50). Conclusion Circulating low 25(OH)D is a risk factor for hyperglycemia, as assessed by HbA1c, in AAM. The 25(OH)D level is an independent determinant of HbA1c in AAM, but not in CAM, including men with and without diabetes.

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Determinants of Circulating 25-Hydroxyvitamin D and bone Mineral Density in Young Physicians

Cited by 9 publications

References 34 publications

Vitamin D levels and deficiency with different occupations: a systematic review

Vitamin D levels and deficiency with different occupations: a systematic review

Vitamin D deficiency and low bone mineral density in native Chinese rheumatoid arthritis patients

Relationship Between Glycated Hemoglobin and Circulating 25-Hydroxyvitamin D Concentration In African American And Caucasian American Men

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