Department of Thyroid and Bone Mineral Diseases, University Hospital of Endocrinology, Medical University of Sofia, 2 ZdraveStr, Sofia 1431, Bulgaria.
Arch Osteoporos. 2013;8:133. doi: 10.1007/s11657-013-0133-4. Epub 2013 Mar 23.
We assume that 25(OH)D level >50 nmol/l is necessary for adequate parathyroid hormone (PTH) suppression in our population. The epidemiology of vitamin D status in Bulgarian population shows deficiency in 21.3 %, insufficiency in 54.5 % and sufficiency in 24.2 %. The mean level of 25(ОН)D for the Bulgarian population is 38.75 nmol/l (95 % CI, 38.00-39.49).
The aim of the present study was to investigate the vitamin D levels in Bulgaria and the prevalence of vitamin D deficiency depending on gender and age, as well as to define population-specific 25(OH)D sufficiency thresholds through the relationship with PTH.
This cross-sectional study was conducted in January-February 2012 and included 2,032 subjects in 12 regions-1,076 women (53 %) and 956 men (47 %), mean age 49.30 ± 14.75 years (20-80 years), divided into three age groups: young (20-44 years, n = 894), middle-aged (45-59 years, n = 534), and elderly (≥60 years, n = 604). 25(OH)D and PTH were measured in all subjects.
The mean level of 25(ОН)D was 38.75 nmol/l (95 % CI, 38.00-39.49). The men had significantly higher 25(ОН)D levels in comparison to women (41.51 nmol/l (95 % CI, 40.45-42.56) vs.36.29 nmol/l (95 % CI, 35.27-37.32), p < 0.05). We did not find significant differences in the 25(ОН)D levels between the three age groups. The prevalence of vitamin D deficiency was 21.3 %; insufficiency, 54.5 %; and sufficiency, 24.2 %. Deficiency was more prevalent in women (26.9 %) than in men (15.1 %), p < 0.001. PTH started to rise over the upper limit of the reference range at mean 25(OH)D 50 nmol/l. We assume that levels over 50 nmol/l are necessary for adequate PTH suppression.
The status of vitamin D in our country is worrisome, and it is largely underestimated. The defining of a vitamin D sufficiency levels may help the devising of adequate strategies for prevention and treatment in clinical practice.
本研究旨在调查保加利亚的维生素 D 水平以及维生素 D 缺乏的流行率，按性别和年龄进行划分，并通过与甲状旁腺激素（PTH）的关系来确定特定人群的 25（OH）D 充足阈值。
这是一项横断面研究，于 2012 年 1 月至 2 月进行，共纳入 12 个地区的 2032 名受试者，包括 1076 名女性（53%）和 956 名男性（47%），平均年龄为 49.30±14.75 岁（20-80 岁），分为三个年龄组：青年组（20-44 岁，n=894）、中年组（45-59 岁，n=534）和老年组（≥60 岁，n=604）。所有受试者均测量 25（OH）D 和 PTH。
25（OH）D 的平均水平为 38.75 nmol/l（95%CI，38.00-39.49）。与女性相比，男性的 25（OH）D 水平显著更高（41.51 nmol/l（95%CI，40.45-42.56）比 36.29 nmol/l（95%CI，35.27-37.32），p<0.05）。我们没有发现三个年龄组之间 25（OH）D 水平有显著差异。维生素 D 缺乏的患病率为 21.3%；不足为 54.5%；充足为 24.2%。女性（26.9%）的维生素 D 缺乏患病率高于男性（15.1%），p<0.001。当平均 25（OH）D 水平达到 50 nmol/l 时，PTH 开始超过参考范围的上限。我们假设 50 nmol/l 以上的水平对于 PTH 的充分抑制是必要的。
我国维生素 D 状况令人担忧，且很大程度上被低估。确定维生素 D 充足水平可能有助于制定临床实践中适当的预防和治疗策略。
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