Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA.
Nutrition and Genomics Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.
J Nutr. 2021 Apr 8;151(4):999-1007. doi: 10.1093/jn/nxaa426.
Vitamin D deficiency has been associated with health problems globally, but there is limited information on vitamin D status and associated risk factors among adults in underserved populations.
This study aimed to identify risk factors for vitamin D deficiency/insufficiency among Puerto Rican adults from the Boston Puerto Rican Health Study (BPRHS).
A total of 822 adults (45-75 y, at baseline) were included in these analyses. Deficiency was defined as serum 25-hydroxyvitamin D [25(OH)D] <30 and insufficiency as 30 to <50 nmol/L. Dietary intake was assessed with a validated FFQ. Associations between risk factors, including dietary vitamin D, supplement use, ancestry, skin pigmentation, months in the past year spent in a southern climate, and serum 25(OH)D were assessed with multivariable general linear models.
Approximately 13% of participants were deficient in 25(OH)D and another 43% insufficient. Skin pigment was associated with 25(OH)D using 3 measures, greater African ancestry (β ± SE) (-7.74 ± 2.91, P = 0.01); interviewer assessed dark or medium, compared with white, skin tone, (-5.09 ± 2.19, P = 0.02 and -5.89 ± 1.58, P < 0.001, respectively); and melanin index of the upper inner right arm, assessed using a spectrophotometer (-2.04 ± 0.84, P = 0.02). After adjusting for ancestry, factors associated with lower serum 25(OH)D included smoking (-4.49 ± 1.58, P = 0.01); BMI (-0.21 ± 0.10, P = 0.04); and spring compared with autumn blood draw (-4.66 ± 1.68, P = 0.004). Factors associated with higher serum 25(OH)D included female sex compared with male (4.03 ± 1.58, P = 0.01); dietary vitamin D intake μg/d (0.71 ± 0.25, P < 0.004); vitamin D supplement use (4.50 ± 1.87, P = 0.02); income to poverty ratio (0.01 ± 0.01, P = 0.06), and months in a southern climate during the past year (0.96 ± 0.56, P = 0.09).
Vitamin D deficiency/insufficiency was prevalent in this Puerto Rican population living in the northeastern USA. Several factors were associated with this, which may assist in identifying those at risk. Interventions are needed to improve serum 25(OH)D concentration, particularly among those with limited exposure to sunlight.
维生素 D 缺乏与全球范围内的健康问题有关，但在服务不足人群的成年人中，关于维生素 D 状况和相关危险因素的信息有限。
本研究旨在确定波多黎各成年人（来自波士顿波多黎各健康研究（BPRHS））维生素 D 缺乏/不足的危险因素。
共纳入 822 名成年人（45-75 岁，基线时）进行这些分析。缺乏症定义为血清 25-羟维生素 D [25(OH)D] <30，不足为 30 至 <50 nmol/L。饮食摄入量通过经过验证的 FFQ 进行评估。使用多变量一般线性模型评估包括膳食维生素 D、补充剂使用、祖源、皮肤色素沉着、过去一年中在南方气候下度过的月份以及血清 25(OH)D 之间的风险因素之间的关联。
大约 13%的参与者血清 25(OH)D 缺乏，另有 43%的参与者血清 25(OH)D 不足。皮肤色素沉着与 25(OH)D 采用 3 种测量方法相关，更大的非洲祖源（β±SE）（-7.74±2.91，P=0.01）；与白人相比，访谈者评估的深色或中等肤色，（-5.09±2.19，P=0.02 和-5.89±1.58，P<0.001，分别）；以及使用分光光度计评估的右上臂内侧黑色素指数（-2.04±0.84，P=0.02）。在校正祖源后，与较低血清 25(OH)D 相关的因素包括吸烟（-4.49±1.58，P=0.01）；BMI（-0.21±0.10，P=0.04）；与春季相比，秋季采血（-4.66±1.68，P=0.004）。与较高血清 25(OH)D 相关的因素包括女性（4.03±1.58，P=0.01）；膳食维生素 D 摄入量μg/d（0.71±0.25，P<0.004）；维生素 D 补充剂使用（4.50±1.87，P=0.02）；收入与贫困比率（0.01±0.01，P=0.06），以及过去一年中在南方气候下度过的月份（0.96±0.56，P=0.09）。
居住在美国东北部的波多黎各人群中普遍存在维生素 D 缺乏/不足。有几个因素与之相关，这可能有助于识别风险人群。需要采取干预措施来提高血清 25(OH)D 浓度，特别是在那些阳光照射有限的人群中。
