Hussain Aneela N, Alkhenizan Abdullah Hamad, El Shaker Mohammad, Raef Hussein, Gabr Alia
Department of Family Medicine and Polyclinic, King Faisal Specialist Hospital & Research Center, P.O. Box 3354, MBC-62, Riyadh, 11211, Saudi Arabia,
Arch Osteoporos. 2014;9:190. doi: 10.1007/s11657-014-0190-3. Epub 2014 Sep 12.
Vitamin D deficiency is highly prevalent in Saudi Arabia, particularly among young women and is emerging as public health threat of epidemic proportions. Prevalence of severe hypovitaminosis D is expected to rise exponentially without primary intervention. This largest study encompasses extent of vitamin D deficiency and recommendations to reduce significant health care burden.
The aim of the study was to determine the prevalence and significance of vitamin D deficiency in Saudi population and to help develop national consensus for its prevention, screening, and management.
This was a retrospective observational study which involved 10,709 patients, recruited from the Department of Family Medicine and Polyclinic, King Faisal Specialist Hospital and Research Center (KFSH&RC), Saudi Arabia, over a period of 5 years. The endpoints included overall status of vitamin D level and severity of vitamin D deficiency. Serum measurements included 25 hydroxyvitamin D (25(OH)D), parathormone, calcium, phosphate, alkaline phosphatase, albumin levels, eGFR levels, bone mineral density.
A total of 10,709 patients were analyzed; 31.4 % were males and 68.6 % were females, with a preponderance of Saudis (68.5 %) compared to non-Saudis (31.5 %). The prevalence of vitamin D deficiency was 83.6 % (31.9 % severe, 32.0 % moderate, and 19.7 % mild), when cut points of less than 25, 50, and 75 nmol/l, respectively, were used. Mean serum 25(OH)D was 44.58 ± 34.80 standard deviation (SD) nmol/l. There was significant difference in severity of vitamin D deficiency stratified by age, gender, and nationality. More females had severe 25(OH)D deficiency compared to males (35.6 vs. 23.7 %, p < 0.000). Severe 25(OH)D deficiency was markedly high among adolescents as compared to other age groups (49.2 vs. 30.9 %, p < 0.000). More Saudis were found to be vitamin D deficient compared to non-Saudis (37.2 vs. 20.3 %, p < 0.000).
The prevalence of hypovitaminosis D is significantly high among Saudi population, especially among women, despite abundant sunshine. It is a major public health concern and requires a robust health policy for vitamin D supplementation and implementation of dietary public health measures. Vitamin D screening is strongly recommended at an earlier age especially among women and children.
维生素D缺乏在沙特阿拉伯极为普遍，尤其是在年轻女性中，正成为一种具有流行规模的公共卫生威胁。如果不进行一级干预，严重维生素D缺乏症的患病率预计将呈指数级上升。这项规模最大的研究涵盖了维生素D缺乏的程度以及减轻重大医疗负担的建议。
本研究的目的是确定沙特人群中维生素D缺乏的患病率及其重要性，并帮助就其预防、筛查和管理达成全国共识。
这是一项回顾性观察研究，涉及从沙特阿拉伯法赫德国王专科医院和研究中心（KFSH&RC）家庭医学和综合诊所招募的10709名患者，研究时间为5年。终点包括维生素D水平的总体状况和维生素D缺乏的严重程度。血清检测项目包括25羟维生素D（25(OH)D）、甲状旁腺激素、钙、磷、碱性磷酸酶、白蛋白水平、估算肾小球滤过率（eGFR）水平、骨密度。
共分析了10709名患者；男性占31.4%，女性占68.6%；沙特人（68.5%）比非沙特人（31.5%）占比更高。当分别采用低于25、50和75 nmol/l的切点时，维生素D缺乏的患病率为83.6%（严重缺乏占31.9%，中度缺乏占32.0%，轻度缺乏占19.7%）。血清25(OH)D的平均水平为44.58±34.80标准差（SD）nmol/l。按年龄、性别和国籍分层的维生素D缺乏严重程度存在显著差异。女性严重25(OH)D缺乏的比例高于男性（35.6%对23.7%，p<0.000）。与其他年龄组相比，青少年中严重25(OH)D缺乏的比例明显更高（49.2%对30.9%，p<0.000）。沙特人维生素D缺乏的比例高于非沙特人（37.2%对20.3%，p<0.000）。
尽管阳光充足，但沙特人群中维生素D缺乏症的患病率仍然很高。尤其是在女性中。这是一个重大的公共卫生问题，需要制定强有力的维生素D补充健康政策并实施饮食公共卫生措施。强烈建议在较早年龄进行维生素D筛查，尤其是在妇女和儿童中。
