Hypovitaminosis D among unselected medical inpatients and outpatients in Northern Italy

Abstract

We read with interest the recent review article by Mosekilde clearly documenting that vitamin D insufficiency/deficiency is a very common condition among individuals in southern European countries, especially among geriatric patients and those with hip fractures. 1 Because the available data on large population samples in Italy are limited, we would like to offer recent findings from our observational study, in which serum 25-hydroxyvitamin D3 concentrations [25(OH)D] were measured using an automated chemiluminescence immunoassay (DiaSorin LIAISON, Stillwater, MN, USA; withinand between-assay precision below 9% and 13%; analytical and functional sensitivity of 12·5 and 17·5 nmol/l, respectively) in a large sample of individuals with a wide range of age (6 months − 103 years).We studied 6403 (male/female = 1299/5104) medical inpatients and outpatients who consecutively attended the laboratory of the Hospital of Vicenza (a town in Northern Italy) for 25(OH)D measurements during the last 3 years.The mean ( ± SD) serum 25(OH)D concentration for the whole population was 45·0 ± 42 nmol/l (median 36; range 12·5-862). As shown in Table 1, there was a strong, inverse, association between serum 25(OH)D levels and age both in men and women. No significant seasonal differences in serum 25(OH)D measurements were found. Among these subjects, 52·5% ( n = 3359) had a serum 25(OH)D concentration ≤ 37·5 nmol/l with percentages steadily increasing with advancing age and ranging from 26·9% to 72·9% in men and from 39·1% to 74·8% in women. Approximately 20% ( n = 1299) of subjects had a very low 25(OH)D concentration ( ≤ 12·5 nmol/l) with percentages ranging from 11·1% to 40·2% in men and from 12·5% to 43·1% in women.Because this is not a population-based study, we stress that our results do not apply to non-institutionalized people, among whom vitamin D deficiency may be (much) lower.In conclusion, we found a high prevalence of vitamin D deficiency among unselected medical inpatients and outpatients, with a wide range of age, living in Northern Italy. Because of the potential adverse effects of vitamin D deficiency on the skeleton and other organ systems, widespread screening for vitamin D deficiency or routine vitamin D supplementation should be seriously considered.

Vitamin D deficiency is associated with type 2 diabetes mellitus in HIV infection

“…The prevalence of vitamin D deficiency in our population was higher than in several previous studies, which reported prevalences of 12% to 47% [12–16]. In contrast, a large Italian study of more than 6000 outpatients and inpatients reported a 52% prevalence of vitamin D deficiency [21]. The higher prevalence of vitamin D deficiency in this study may be related to the northern geographic location of Modena (44°N) which may lead to more indoor activities and less sun exposure.…”

Lower levels of 25-hydroxyvitamin D3are associated with a higher prevalence of microvascular complications in patients with type 2 diabetes

“…Similar findings have been reported by other investigators among 6403 unselected medical inpatients and outpatients, who attended the laboratory Hospital of Vicenza, a town in Northern Italy. 19 …”

Vitamin D deficiency among Italian children

“…[1][2][3] We agree with Danielle Grenier that, in addition to heightened efforts by individual health care providers, more rigorous national surveillance is needed to ensure adequate vitamin D intake by pregnant and lactating women and to improve the health and well-being of children and youth. We are pleased that our national data 1 have spurred an interest in defining the vitamin D status of children and adolescents in other countries.…”