Samsung Health Research Institute, Samsung Electronics Co. Ltd., Hwaseong-si 18448, Korea.
Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul 03080, Korea.
Int J Environ Res Public Health. 2020 Dec 8;17(24):9166. doi: 10.3390/ijerph17249166.
While exposure to sunlight is a well-documented primary source of vitamin D supply, factors leading to vitamin D deficiency vary according to population characteristics. Using nationwide data from the Korea National Health and Nutrition Examination Survey (KNHANES), we aimed to investigate a diverse range of potential factors in association with vitamin D deficiency. Overall, 21,208 participants aged ≥20 years were selected from KNHANES conducted between 2010 and 2014. The associations between various environmental and occupational factors and vitamin D deficiency (defined as serum 25-hydroxyvitamin D [25(OH)D] < 20 ng/mL) were evaluated in logistic regression models after controlling for potential covariates and also after stratification for age and sex. Under given criteria, 15,138 (71.4%) participants were vitamin D deficient. Significant associations were observed between vitamin D deficiency and average environmental temperature and radiation, weekly walking frequency, type of occupation, and shift work. When participants were stratified by age and sex, we observed greater associations of vitamin D deficiency with walking frequency among young males (odds ratio [OR] and 95% confidence interval [95% CI]: 1.24 [1.05-1.47] for those walking <5 times per week compared to those walking ≥5 times per week) and shift work (OR [95% CI]: 1.40 [1.10-1.78] for those working at night compared to those working during the day). We also observed a significant association of vitamin D deficiency with educational attainment (OR [95% CI]: 1.43 [1.09-1.89] for those with ≤middle school compared to those with ≥high school) among older group of females. This study suggests that vitamin D deficiency is related to geographical conditions and subpopulation characteristics. The age and sex-specific associations may urge the effective promotion of vitamin D supply recommendations.
尽管暴露在阳光下是维生素 D 供应的一个有充分记录的主要来源，但导致维生素 D 缺乏的因素因人群特征而异。我们使用了韩国国家健康和营养检查调查（KNHANES）的全国性数据，旨在研究与维生素 D 缺乏相关的各种潜在因素。总体而言，从 2010 年至 2014 年进行的 KNHANES 中选择了 21,208 名年龄≥20 岁的参与者。在控制了潜在的混杂因素后，我们使用逻辑回归模型评估了各种环境和职业因素与维生素 D 缺乏（定义为血清 25-羟维生素 D [25(OH)D] < 20ng/mL）之间的关联，并在年龄和性别分层后进行了评估。根据给定的标准，15,138（71.4%）名参与者患有维生素 D 缺乏症。维生素 D 缺乏症与平均环境温度和辐射、每周步行频率、职业类型和轮班工作之间存在显著关联。当按年龄和性别对参与者进行分层时，我们观察到在年轻男性中，步行频率与维生素 D 缺乏症的关联更大（与每周步行<5 次的参与者相比，每周步行≥5 次的参与者的比值比[OR]和 95%置信区间[95%CI]：1.24[1.05-1.47]），与轮班工作（与白天工作的参与者相比，夜间工作的参与者的 OR [95%CI]：1.40[1.10-1.78]）之间的关联更大。我们还观察到在年龄较大的女性中，维生素 D 缺乏症与教育程度（与接受过中学及以下教育的参与者相比，接受过高中及以上教育的参与者的 OR [95%CI]：1.43[1.09-1.89]）之间存在显著关联。本研究表明，维生素 D 缺乏与地理位置和亚人群特征有关。年龄和性别特异性关联可能迫切需要有效促进维生素 D 供应建议。
