Department of Medical Genetics, NHC Key Laboratory of Periconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Kunming, China.
School of Medicine, Kunming University of Science and Technology, Kunming, China.
Nutr Bull. 2023 Dec;48(4):535-545. doi: 10.1111/nbu.12645. Epub 2023 Oct 21.
Vitamin D deficiency is widespread in different populations and regions worldwide and has become a global health issue. The vitamin D status of the population in the Yunnan Province of Southwest China has not been evaluated to date. Therefore, in this study, we evaluated the vitamin D status according to the serum concentrations of 25-hydroxyvitamin D (25(OH)D) in individuals of Yunnan Province, a low-latitude, high-altitude and multiracial region in China. The data on 25(OH)D concentrations from October 2012 to December 2017 were retrospectively collected and assessed using the laboratory information system from 52 950 hospital-based participants (age, 1 day-96 years; females, 73.74%). The serum concentration of 25(OH)D was evaluated using a chemiluminescent immunoassay. The analysis was stratified by sex, age, sampling season, testing year, minority, residential district, latitude, altitude and meteorological factors. Vitamin D status was classified as follows: severe deficiency: <10 ng/mL; deficiency: <20 ng/mL; insufficiency: <30 ng/mL; and sufficiency: ≥30 ng/mL. The results showed that vitamin D deficiency is highly prevalent in Yunnan Province in a hospital-based cohort, with a deficiency and severe deficiency rate of 65.1% and a sufficiency rate of 5.30%. Significantly lower vitamin D levels and sufficiency rates were observed in females than in males (20.13 ± 7.22 ng/mL vs. 17.56 ± 6.66 ng/mL and 8.20% vs. 4.20%; p < 0.01, respectively); in spring and winter (16.93 ± 6.24 ng/mL; 2.97% and 16.38 ± 6.43 ng/mL; 3.06%, respectively) than in summer and autumn (20.23 ± 7.14 ng/mL; 8.02% and 19.10 ± 6.97 ng/mL; 6.61% [p < 0.01], respectively); and in older individuals (0-6 years: 28.29 ± 13.13 ng/mL vs. >60 years: 14.88 ± 8.39 ng/mL; p < 0.01). Relatively higher vitamin D levels were observed in individuals of Yi, Zhuang, Hani, Dai, Miao and Lisu minorities and lower levels in individuals of Hui and Zang minorities compared with those of the Han nationality (p < 0.01). The mean sunlight duration, mean air temperature, maximum ultraviolet value and latitude were significantly correlated with vitamin D levels (r = -0.53, 0.60, 0.31, -0.68, respectively; p < 0.05). These results suggest that vitamin D status is influenced by sex, age, minority, latitude and some meteorological factors in areas with high and low altitudes. Hence, new public health policies, such as advice on sunshine exposure, food fortification and nutrition education, as well as the implementation of vitamin D supplementation programmes must be considered to alleviate vitamin D deficiency in Yunnan province, Southwest China.
维生素 D 缺乏在全球不同人群和地区普遍存在，已成为全球性健康问题。中国西南云南省的人群维生素 D 状况尚未得到评估。因此，本研究通过检测血清 25-羟维生素 D [25(OH)D]浓度评估了云南省人群的维生素 D 状况。研究回顾性收集了 2012 年 10 月至 2017 年 12 月间的 52950 例医院就诊者（年龄 1 天-96 岁；女性占 73.74%）的 25(OH)D 浓度数据，并使用实验室信息系统进行评估。血清 25(OH)D 浓度采用化学发光免疫分析法进行检测。分析按性别、年龄、采样季节、检测年份、少数民族、居住地区、纬度、海拔和气象因素进行分层。维生素 D 状况的分类如下：严重缺乏：<10ng/ml；缺乏：<20ng/ml；不足：<30ng/ml；充足：≥30ng/ml。结果显示，云南省医院就诊者维生素 D 缺乏情况普遍严重，缺乏和严重缺乏率为 65.1%，充足率为 5.30%。女性维生素 D 水平和充足率显著低于男性（20.13±7.22ng/ml比 17.56±6.66ng/ml和 8.20%比 4.20%；p均<0.01）；春季和冬季（16.93±6.24ng/ml；2.97%和 16.38±6.43ng/ml；3.06%）显著低于夏季和秋季（20.23±7.14ng/ml；8.02%和 19.10±6.97ng/ml；6.61%；p均<0.01）；年龄较大者（0-6 岁：28.29±13.13ng/ml；>60 岁：14.88±8.39ng/ml；p均<0.01）维生素 D 水平较低。与汉族相比，彝族、壮族、哈尼族、傣族、苗族和傈僳族的维生素 D 水平相对较高，回族和藏族的维生素 D 水平较低（p均<0.01）。平均日照时间、平均空气温度、最大紫外线值和纬度与维生素 D 水平显著相关（r值分别为-0.53、0.60、0.31、-0.68；p均<0.05）。这些结果提示，海拔高低地区的维生素 D 状况受性别、年龄、少数民族、纬度和部分气象因素的影响。因此，应考虑制定新的公共卫生政策，如建议阳光暴露、食物强化和营养教育，以及实施维生素 D 补充方案，以缓解云南省维生素 D 缺乏状况。
