Skip to main content
Erschienen in: Journal of General Internal Medicine 8/2007

01.08.2007 | Populations at Risk

Prevalence of Vitamin D Deficiency in Uninsured Women

verfasst von: Radhika R. Kakarala, MD, Sreenivasa R. Chandana, MD, PhD, Susan S. Harris, DSc, Lakshmi P. Kocharla, MD, Elena Dvorin, MD, PhD

Erschienen in: Journal of General Internal Medicine | Ausgabe 8/2007

Einloggen, um Zugang zu erhalten

Abstract

Background

Vitamin D deficiency, an important risk factor for osteoporosis and other chronic medical conditions, is epidemic in the United States. Uninsured women may be at an even higher risk for vitamin D deficiency than others owing to low intake of dietary and supplemental vitamin D and limited sun exposure.

Objective

Our goal was to determine the prevalence of vitamin D deficiency in this vulnerable population.

Setting and Participants

We enrolled 145 uninsured women at a County Free Medical Clinic in urban Michigan. Questionnaires were used to obtain information about demographics, medical history, vitamin supplementation, sunlight exposure, and dietary vitamin D intake.

Results

The 96 women who were tested for vitamin D status ranged in age from 21 to 65 years (mean 48 ± 11), and 67% were vitamin D deficient as indicated by a 25-hydroxyvitamin D [25(OH)D)] level <50 nmol/L (20 ng/mL). Non-Caucasians were 3 times more likely than Caucasians to be vitamin D deficient (P = .049). Mean dietary vitamin D intake was low (125 ± 109 IU/d) and only 24% of the participants used any supplemental vitamin D. Participants with total vitamin D intake <400 IU/day from diet and supplements were 10 times more likely to be vitamin D deficient than others (P < .001).

Conclusions

These results demonstrate a high prevalence of vitamin D deficiency in an uninsured, medically underserved female population. Uninsured women should be strongly encouraged to increase their vitamin D intake.
Literatur
2.
Zurück zum Zitat Tangpricha V, Pearce EN, Chen TC, Holick MF. Vitamin D insufficiency among free-living healthy young adults. Am J Med. 2002;112(8):659–62.PubMedCrossRef Tangpricha V, Pearce EN, Chen TC, Holick MF. Vitamin D insufficiency among free-living healthy young adults. Am J Med. 2002;112(8):659–62.PubMedCrossRef
3.
Zurück zum Zitat Nesby-O’Dell S, Scanlon KS, Cogswell ME, et al. Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: third National Health and Nutrition Examination Survey, 1988–1994. Am J Clin Nutr. 2002;76(1):187–92.PubMed Nesby-O’Dell S, Scanlon KS, Cogswell ME, et al. Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: third National Health and Nutrition Examination Survey, 1988–1994. Am J Clin Nutr. 2002;76(1):187–92.PubMed
4.
Zurück zum Zitat Harris SS, Soteriades E, Coolidge JA, Mudgal S, Dawson-Hughes B. Vitamin D insufficiency and hyperparathyroidism in a low income, multiracial, elderly population. J Clin Endocrinol Metab. 2000;85(11):4125–30.PubMedCrossRef Harris SS, Soteriades E, Coolidge JA, Mudgal S, Dawson-Hughes B. Vitamin D insufficiency and hyperparathyroidism in a low income, multiracial, elderly population. J Clin Endocrinol Metab. 2000;85(11):4125–30.PubMedCrossRef
5.
Zurück zum Zitat Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc. 2003;78(12):1463–70.PubMedCrossRef Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc. 2003;78(12):1463–70.PubMedCrossRef
6.
Zurück zum Zitat Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev. 2001;22(4):477–501. Review.PubMedCrossRef Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev. 2001;22(4):477–501. Review.PubMedCrossRef
7.
Zurück zum Zitat Holick MF. Vitamin D. The underappreciated D-lightful hormone that is important for skeletal and cellular health. Curr Opin Endocrinol Diabetes 2002;9:87–98.CrossRef Holick MF. Vitamin D. The underappreciated D-lightful hormone that is important for skeletal and cellular health. Curr Opin Endocrinol Diabetes 2002;9:87–98.CrossRef
8.
Zurück zum Zitat Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr. 2004;79(5):820–5.PubMed Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr. 2004;79(5):820–5.PubMed
9.
Zurück zum Zitat Lind L, Hanni A, Lithell H, Hvarfner A, Sorensen OH, Ljunghall S. Vitamin D is related to blood pressure and other cardiovascular risk factors in middle-aged men. Am J Hypertens. 1995; 8(9):894–901.PubMedCrossRef Lind L, Hanni A, Lithell H, Hvarfner A, Sorensen OH, Ljunghall S. Vitamin D is related to blood pressure and other cardiovascular risk factors in middle-aged men. Am J Hypertens. 1995; 8(9):894–901.PubMedCrossRef
10.
Zurück zum Zitat Boucher BJ, Mannan N, Noonan K, Hales CN, Evans SJ. Glucose intolerance and impairment of insulin secretion in relation to vitamin D deficiency in east London Asians. Diabetologia. 1995;38(10):1239–45.PubMedCrossRef Boucher BJ, Mannan N, Noonan K, Hales CN, Evans SJ. Glucose intolerance and impairment of insulin secretion in relation to vitamin D deficiency in east London Asians. Diabetologia. 1995;38(10):1239–45.PubMedCrossRef
11.
Zurück zum Zitat Gedik O, Akalin S. Effects of vitamin D deficiency and repletion on insulin and glucagon secretion in man. Diabetologia. 1986;29(3):142–5.PubMedCrossRef Gedik O, Akalin S. Effects of vitamin D deficiency and repletion on insulin and glucagon secretion in man. Diabetologia. 1986;29(3):142–5.PubMedCrossRef
12.
Zurück zum Zitat Trivedi DP, Doll R, Khaw KT. Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial. BMJ. 2003; 326(7387):469–72.PubMedCrossRef Trivedi DP, Doll R, Khaw KT. Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial. BMJ. 2003; 326(7387):469–72.PubMedCrossRef
13.
Zurück zum Zitat Malabanan A, Veronikis IE, Holick MF. Redefining vitamin D insufficiency. Lancet. 1998;351(9105):805–6.PubMedCrossRef Malabanan A, Veronikis IE, Holick MF. Redefining vitamin D insufficiency. Lancet. 1998;351(9105):805–6.PubMedCrossRef
14.
Zurück zum Zitat Bischoff-Ferrari HA, Dawson-Hughes B, Willett WC, et al. Effect of Vitamin D on falls: a meta-analysis. JAMA. 2004;291(16):1999–2006. Review.PubMedCrossRef Bischoff-Ferrari HA, Dawson-Hughes B, Willett WC, et al. Effect of Vitamin D on falls: a meta-analysis. JAMA. 2004;291(16):1999–2006. Review.PubMedCrossRef
15.
Zurück zum Zitat Fiscella K. Is lower income associated with greater biopsychosocial morbidity? Implications for physicians working with underserved patients. J Fam Pract. 1999;48(5):372–7.PubMed Fiscella K. Is lower income associated with greater biopsychosocial morbidity? Implications for physicians working with underserved patients. J Fam Pract. 1999;48(5):372–7.PubMed
16.
Zurück zum Zitat Reed MC, Tu HT. Triple jeopardy: low income, chronically ill and uninsured in America. Issue Brief Cent Stud Health Syst Change. 2002;(49):1–4. Reed MC, Tu HT. Triple jeopardy: low income, chronically ill and uninsured in America. Issue Brief Cent Stud Health Syst Change. 2002;(49):1–4.
19.
Zurück zum Zitat Holick MF, Siris ES, Binkley N, et al. Prevalence of vitamin D inadequacy among postmenopausal north American woman receiving osteoporosis therapy. J Clin Endocrinol Metab. 2005;90(6):3215–24.PubMedCrossRef Holick MF, Siris ES, Binkley N, et al. Prevalence of vitamin D inadequacy among postmenopausal north American woman receiving osteoporosis therapy. J Clin Endocrinol Metab. 2005;90(6):3215–24.PubMedCrossRef
20.
Zurück zum Zitat Blalock SJ, Norton LL, Patel RA, Cabral K, Thomas CL. Development and assessment of a short instrument for assessing dietary intakes of calcium and vitamin D. J Am Pharm Assoc (Wash DC). 2003;43(6):685–93. Blalock SJ, Norton LL, Patel RA, Cabral K, Thomas CL. Development and assessment of a short instrument for assessing dietary intakes of calcium and vitamin D. J Am Pharm Assoc (Wash DC). 2003;43(6):685–93.
21.
Zurück zum Zitat Kauppinen-Makelin R, Tahtela R, Loyttyniemi E, Karkkainen J, Valimaki MJ. A high prevalence of hypovitaminosis D in Finnish medical in- and outpatients. J Intern Med. 2001; 249(6):559–63.PubMedCrossRef Kauppinen-Makelin R, Tahtela R, Loyttyniemi E, Karkkainen J, Valimaki MJ. A high prevalence of hypovitaminosis D in Finnish medical in- and outpatients. J Intern Med. 2001; 249(6):559–63.PubMedCrossRef
22.
Zurück zum Zitat Lips P, Duong T, Oleksik A, Black, et al. A global study of vitamin D status and parathyroid function in postmenopausal women with osteoporosis: baseline data from the multiple outcomes of raloxifene evaluation clinical trial. J Clin Endocrinol Metab. 2001;86(3):1212–21.PubMedCrossRef Lips P, Duong T, Oleksik A, Black, et al. A global study of vitamin D status and parathyroid function in postmenopausal women with osteoporosis: baseline data from the multiple outcomes of raloxifene evaluation clinical trial. J Clin Endocrinol Metab. 2001;86(3):1212–21.PubMedCrossRef
23.
Zurück zum Zitat Harris SS, Soteriades E, Dawson-Hughes B. Secondary hyperparathyroidism and bone turnover in elderly blacks and whites. J Clin Endocrinol Metab. 2001;86:3801–3804PubMedCrossRef Harris SS, Soteriades E, Dawson-Hughes B. Secondary hyperparathyroidism and bone turnover in elderly blacks and whites. J Clin Endocrinol Metab. 2001;86:3801–3804PubMedCrossRef
24.
Zurück zum Zitat Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R. Estimates of optimal vitamin D status. Osteoporosis Int. 2005;16:713–6.CrossRef Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R. Estimates of optimal vitamin D status. Osteoporosis Int. 2005;16:713–6.CrossRef
25.
Zurück zum Zitat Harris SS, Dawson-Hughes B. Seasonal changes in plasma 25hydroxyvitamin D concentrations of young American black and white women. Am J Clin Nutr. 1998;67(6):1232–6.PubMed Harris SS, Dawson-Hughes B. Seasonal changes in plasma 25hydroxyvitamin D concentrations of young American black and white women. Am J Clin Nutr. 1998;67(6):1232–6.PubMed
26.
Zurück zum Zitat Looker AC, Dawson-Hughes B, Calvo MS, Gunter EW, Sahyoun NR. Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. Bone. 2002;30(5):771–7.PubMedCrossRef Looker AC, Dawson-Hughes B, Calvo MS, Gunter EW, Sahyoun NR. Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. Bone. 2002;30(5):771–7.PubMedCrossRef
27.
Zurück zum Zitat Moore CE, Murphy MM, Holick MF. Vitamin D intakes by children and adults in the United States differ among ethnic groups. J Nutr 2005;135:2478–85PubMed Moore CE, Murphy MM, Holick MF. Vitamin D intakes by children and adults in the United States differ among ethnic groups. J Nutr 2005;135:2478–85PubMed
Metadaten
Titel
Prevalence of Vitamin D Deficiency in Uninsured Women
verfasst von
Radhika R. Kakarala, MD
Sreenivasa R. Chandana, MD, PhD
Susan S. Harris, DSc
Lakshmi P. Kocharla, MD
Elena Dvorin, MD, PhD
Publikationsdatum
01.08.2007
Verlag
Springer-Verlag
Erschienen in
Journal of General Internal Medicine / Ausgabe 8/2007
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-007-0245-x

Weitere Artikel der Ausgabe 8/2007

Journal of General Internal Medicine 8/2007 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren. 

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Wo hapert es noch bei der Umsetzung der POMGAT-Leitlinie?

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

VHF-Ablation nützt wohl nur bei reduzierter Auswurfleistung

02.05.2024 Ablationstherapie Nachrichten

Ob die Katheterablation von Vorhofflimmern bei Patienten mit Herzinsuffizienz die Komplikationsraten senkt, scheint davon abzuhängen, ob die Auswurfleistung erhalten ist oder nicht. Das legen die Ergebnisse einer Metaanalyse nahe.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.