Vitamin D status in Armenian women: a stratified cross-sectional cluster analysis
Hutchings N.,1,2 Babalyan V.,2 Heijboer A.C.,3 Baghdasaryan S.,2 Qefoyan M.,2 Ivanyan A.,4 Ackermans M.T.,3 Formenti A.M.,5 Lesnyak O.,6 Giustina A.,5 Bilezikian J.P.7
1 School of Medicine, University of California, Irvine, CA, USA
2 Osteoporosis Center of Armenia, Yerevan, Armenia
3 Endocrine Laboratory, Department of Clinical Chemistry, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, Vrije Universiteit Amsterdam & University of Amsterdam, Amsterdam, The Netherlands
4 Yerevan State Medical University, Yerevan, Armenia
5 Institute of Endocrine and Metabolic Sciences, San Raffaele, IRCCS Hospital, Vita-Salute University, Milano, Italy
6 Mechnikov North West State Medical University, Saint Petersburg, Russia
7 College of Physicians and Surgeons, Columbia University, New York, NY, USA
ABSTRACT
Background: Vitamin D plays a critical role in skeletal development and maintenance, thus sufficiency is an important goal for public health programs. Given the absence of foods fortified in vitamin D in Armenia, we hypothesized that vitamin D insufficiency would be widespread.
Methods: We conducted a random modified cluster model survey of vitamin D status of women in the country. We measured 25-hydroxyvitamin D [25(OH)D] by liquid chromatography mass spectrometry in dried blood spot samples and utilized a questionnaire to assess lifestyle factors.
Results: In summer, we sampled 1206 participants from 40 communities in Armenia. Mean 25(OH)D level among women aged 18–24 was 20±8 ng/mL; aged 25–64 was 21±7 ng/mL; and >65 was 18±8 ng/mL. The country-wide mean of the entire female population was 20±8 ng/mL. A majority (>54%) had 25(OH)D levels <20 ng/ mL with nearly 13% having 25(OH)D levels <12 ng/mL. Participants who reported calcium, vitamin D, or multivitamin supplementation had higher levels of 25(OH)D (p values 0.004, 0.0002, and 0.03 respectively) as did prevs. postmenopausal women (p = 0.01), pregnant vs. nonpregnant women (p ≤ 0.0001), and women who had experienced a sunburn in the past year (p = 0.004).
Conclusion: In Armenia, there is a high prevalence of vitamin D insufficiency. This information provides data that can be used to inform public health directives to address this pervasive threat to optimal health.
Keywords: Vitamin D, Armenia, osteoporosis, osteopenia, women