Vitamin D Levels and Prevalence of Vitamin D Deficiency Associated with Sex, Age, Region, and Season in Koreans

Eun Hee Nah; Suyoung Kim; Han-Ik Cho

doi:10.3343/lmo.2015.5.2.84

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Nah, Kim, and Cho: Vitamin D Levels and Prevalence of Vitamin D Deficiency Associated with Sex, Age, Region, and Season in Koreans

Original Article

General Laboratory Medicine

Laboratory Medicine Online 2015; 5(2): 84-91.

Published online: 1 April 2015

DOI: https://doi.org/10.3343/lmo.2015.5.2.84

Vitamin D Levels and Prevalence of Vitamin D Deficiency Associated with Sex, Age, Region, and Season in Koreans

Eun Hee Nah, M.D.¹, Suyoung Kim², Han-Ik Cho, M.D.³

¹Department of Laboratory Medicine, Korea Association of Health Promotion, Seoul, Korea.

²Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea.

³Korea Association of Health Promotion, Seoul, Korea.

Corresponding author: Eun Hee Nah. Department of Laboratory Medicine, Korea Association of Health Promotion, 335 Hwagok-ro, Gangseo-gu, Seoul 157-704, Korea. Tel: +82-2-2600-2000, Fax: +82-2-2696-4500, cellonah@hanmail.net

Received 16 April 2014 Revised 19 June 2014 Accepted 10 July 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Although many studies on vitamin D have been conducted, they have not been consistent regarding the method of measurement, the individuals investigated, and the season of blood sampling. Thus, this study was performed to investigate 25-hydroxy vitamin D [25(OH)D] levels and the prevalence of 25(OH)D deficiency by age, region, and season using the standard method for vitamin D measurement.

Methods

A total of 17,252 health examinees (9,180 men and 8,072 women) who were administered the vitamin D test at 16 health promotion centers in 13 cities in Korea from January to December 2013 were selected for this study. Measurements of 25(OH)D₂ and 25(OH)D₃ were performed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) using the MSMS Vitamin D Kit.

Results

The levels of 25(OH)D were significantly lower among women than men. The median 25(OH)D value was lowest among men and women in their 20s when compared to other age groups. We observed the lowest levels in January and February and the highest levels in August, September, and October. The prevalence of 25(OH)D deficiency (having levels of <10 ng/mL) was significantly higher among women than men. When different age groups were analyzed, the highest rates of 25(OH)D deficiency were found in their 20s, and prevalence decreased with age (up to an age of 60 years). Lastly, the prevalence of 25(OH)D deficiency was highest in Seoul and the Gyeonggi area when compared to other regions.

Conclusions

Level of 25(OH)D and the prevalence of 25(OH)D deficiency differed by sex, age, month (season), and region.

Keywords: 25-hydroxyvitamin D, Vitamin D deficiency, Tandem mass spectrometry

Figures and Tables

Fig. 1

Distribution of serum 25-hydroxy vitamin D [25(OH)D] levels by age groups (men and women). The bottom and top horizontal lines of the box represent the 25th and 75th percentiles, respectively. The band near the middle of the box represents the median value, and the horizontal lines represent the 5th and 95th percentiles. Kruskal-Wallis test, P<0.001.

Fig. 2

Distribution of serum 25-hydroxy vitamin D [25(OH)D] levels by month of examination. The bottom and top horizontal lines of the box represent the 25th and 75th percentiles, respectively. The band near the middle of the box represents the median value, and the horizontal lines represent the 5th and 95th percentiles. Kruskal-Wallis test, P<0.001.

Fig. 3

Prevalence of serum 25-hydroxyvitamin D [25(OH)D] deficiency according to city.

Table 1

The 25-hydroxy vitamin D₂ [25(OH)D₂], 25-hydroxy vitamin D₃ [25(OH)D₃], and total 25-hydroxy vitamin D [25(OH)D] levels

	25(OH)D₂ (ng/mL)	25(OH)D₃ (ng/mL)	Total 25(OH)D (ng/mL)	P value
Sex				< 0.001
Male (N = 9,180)	0.6 ± 1.2	21.5 ± 8.4	21.9 ± 8.5
Female (N = 8,072)	0.7 ± 1.3	18.6 ± 8.7	19.2 ± 8.9
Age (yr)				< 0.001
20-29 (N = 260)	0.6 ± 0.8	16.4 ± 8.2	16.8 ± 8.1
30-39 (N = 2,056)	0.6 ± 0.8	18.2 ± 7.8	18.7 ± 7.9^*
40-49 (N = 4,096)	0.6 ± 1.0	19.5 ± 8.3	19.9 ± 8.3^*
50-59 (N = 6,401)	0.7 ± 1.2	20.7 ± 8.6	21.2 ± 8.7^*
60-69 (N = 3,585)	0.8 ± 1.6	21.2 ± 9.2	21.8 ± 9.3^*
≥ 70 (N = 854)	0.8 ± 1.6	20.6 ± 10.1	21.2 ± 10.1^*
Month				< 0.001
Dec-Feb (N = 4,074)	0.7 ± 1.2	16.3 ± 7.3	16.9 ± 7.5
Mar-May (N = 4,357)	0.7 ± 1.2	17.0 ± 7.6	17.6 ± 7.6^†
Jun-Aug (N = 4,747)	0.6 ± 1.4	23.0 ± 8.3	23.6 ± 8.4^†
Sep-Nov (N = 4,074)	0.7 ± 1.1	23.8 ± 8.8	24.3 ± 8.8^†
Total (N = 17,252)	0.7 ± 1.2	20.1 ± 8.7	20.6 ± 8.8	-

Values are shown as means±standard deviations.

The P value was derived from the Student t-test and one-way ANOVA.

^*P<0.001 derived from posthoc comparisons (Dunnett's test) between the 20-29 years age group and the other age groups; ^†P<0.001 derived from posthoc comparisons (Dunnett's test) between the Dec - Feb group and the other months groups.

Table 2

Prevalence of 25-hydroxy vitamin D [25(OH)D] deficiency, insufficiency, and sufficiency among the study participants by age groups

	Total 25(OH)D levels (ng/mL)				P value^*
	< 10	10 ≤ Vit D < 20	20 ≤ Vit D < 30	30 ≤ Vit D < 100
	N (%)	N (%)	N (%)	N (%)
Men age groups (yr)					< 0.001
20-29	23 (17.0)	68 (50.4)	29 (21.5)	15 (11.1)
30-39	101 (8.3)	578 (47.3)	409 (33.5)	134 (11.0)
40-49	104 (4.3)	1,012 (42.1)	936 (39.0)	350 (14.6)
50-59	87 (2.8)	1,208 (38.4)	1,256 (40.0)	593 (18.9)
60-69	83 (4.5)	714 (38.9)	656 (35.8)	382 (20.8)
≥ 70	30 (6.8)	167 (37.8)	150 (33.9)	95 (21.5)
Total	428 (4.7)	3,747 (40.8)	3,436 (37.4)	1,569 (17.1)
Women age groups (yr)					< 0.001
20-29	29 (23.2)	70 (56.0)	22 (17.6)	4 (3.2)
30-39	118 (14.2)	447 (53.6)	223 (26.7)	46 (5.5)
40-49	264 (15.6)	868 (51.2)	440 (26.0)	122 (7.2)
50-59	313 (9.6)	1,589 (48.8)	932 (28.6)	423 (13.0)
60-69	173 (9.9)	758 (43.3)	500 (28.6)	319 (18.2)
≥ 70	59 (14.3)	192 (46.6)	110 (26.7)	51 (12.4)
Total	956 (11.8)	3,924 (48.6)	2,227 (27.6)	965 (12.0)

^*P value derived from the Chi-square test.

Notes

This article is available from http://www.labmedonline.org

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Vitamin D Levels and Prevalence of Vitamin D Deficiency Associated with Sex, Age, Region, and Season in Koreans

Abstract

Background

Methods

Results

Conclusions

Figures and Tables

Fig. 1

Fig. 2

Fig. 3

Prevalence of serum 25-hydroxyvitamin D [25(OH)D] deficiency according to city.

Table 1

The 25-hydroxy vitamin D2 [25(OH)D2], 25-hydroxy vitamin D3 [25(OH)D3], and total 25-hydroxy vitamin D [25(OH)D] levels

Table 2

Prevalence of 25-hydroxy vitamin D [25(OH)D] deficiency, insufficiency, and sufficiency among the study participants by age groups

Notes

References

The 25-hydroxy vitamin D₂ [25(OH)D₂], 25-hydroxy vitamin D₃ [25(OH)D₃], and total 25-hydroxy vitamin D [25(OH)D] levels