Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Faculty of Medicine, Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
J Steroid Biochem Mol Biol. 2020 May;199:105609. doi: 10.1016/j.jsbmb.2020.105609. Epub 2020 Jan 29.
Vitamin D plays a role in bone and metabolic health in life long, however hypovitaminosis D is common in different settings. The aim of this study was to describe vitamin D status among adolescents from a large sunny country and analyze associated factors. This was a multicenter, cross-sectional, school-based study. A total of 1152 adolescents age 12-17 from four Brazilian cities, Rio de Janeiro, Fortaleza, Brasília, and Porto Alegre, were included. Anthropometric variables, diet, type of school, race and season of data collection were evaluated. Serum concentrations of 25-hydroxyvitamin D [25(OH)D] were measured and categorized into three levels: ≤ 20 ng/mL, 21-29 ng/mL and ≥ 30 ng/mL. Ordered logistic regression models were used to explore the factors associated with hypovitaminosis D. The prevalence of vitamin D levels below 20 ng/mL, between 21 and 29 ng/mL and above 30 ng/mL was 21 % (95 %CI: 19 %-24 %), 42 % (95 %CI: 39 %-46 %) and 37 % (95 %CI: 33 %-40 %), respectively. In the final adjusted model, hypovitaminosis D was positively associated with gender, center (latitudes), data collected in winter or spring, non-whites, and private school students. A higher proportional odds ratio (POR) for hypovitaminosis D was found among obese boys (POR = 2.2, 95 %CI: 1.1-4.5), but not girls. Adequate dietary intake of vitamin D was a protective factor (POR = 0.4, 95 %CI: 0.2-0.6) against hypovitaminosis D. In conclusion, there is a high prevalence of Brazilian adolescents at risk of hypovitaminosis D, independent of region. Due to their potential benefits, lifestyle changes should be stimulated, including healthier food choices and spending more time outdoors (with sun protection).
维生素 D 在骨骼和代谢健康方面起着重要作用，然而，维生素 D 缺乏症在不同环境中很常见。本研究旨在描述来自阳光充足的大国的青少年的维生素 D 状况，并分析相关因素。这是一项多中心、横断面、基于学校的研究。共纳入来自巴西四个城市（里约热内卢、福塔莱萨、巴西利亚和阿雷格里港）的 1152 名 12-17 岁的青少年。评估了人体测量变量、饮食、学校类型、种族和数据采集季节。测量了血清 25-羟维生素 D [25(OH)D]浓度，并将其分为三个水平：≤20ng/ml、21-29ng/ml 和≥30ng/ml。采用有序逻辑回归模型探讨与维生素 D 缺乏相关的因素。维生素 D 水平低于 20ng/ml、21-29ng/ml 和高于 30ng/ml 的发生率分别为 21%（95%CI：19%-24%）、42%（95%CI：39%-46%）和 37%（95%CI：33%-40%）。在最终调整后的模型中，维生素 D 缺乏与性别、中心（纬度）、冬季或春季采集的数据、非白人和私立学校学生呈正相关。超重男孩（POR=2.2，95%CI：1.1-4.5）患维生素 D 缺乏症的比例优势比（POR）更高，但女孩则不然。维生素 D 的适当膳食摄入量是预防维生素 D 缺乏症的保护因素（POR=0.4，95%CI：0.2-0.6）。总之，巴西青少年有很高的维生素 D 缺乏风险，且与地区无关。由于潜在的益处，应鼓励生活方式的改变，包括更健康的食物选择和更多的户外活动（有防晒措施）。
