Journal List > J Nutr Health > v.46(6) > 1081320

J Nutr Health. 2013 Dec;46(6):540-551. Korean.
Published online December 31, 2013.  https://doi.org/10.4163/jnh.2013.46.6.540
© 2013 The Korean Nutrition Society
Prevalence of vitamin D deficiency in Korea: Results from KNHANES 2010 to 2011
In Kyung Jung
Department of Beauty Art, Honam University, Gwangju 502-791, Korea.

To whom correspondence should be addressed. (Email: jungik@honam.ac.kr )
Received September 23, 2013; Revised November 18, 2013; Accepted November 20, 2013.

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

Vitamin D deficiency (VDD) is becoming an epidemic and thereby a global health problem. Further, VDD adversely affects calcium metabolism and skeletal health, and is associated with increased risk of several diseases, e.g., autoimmune diseases, several types of cancers, type 2 diabetes mellitus, cardiovascular diseases, infectious diseases, asthma, psoriatic arthritis, and etc. To evaluate the prevalence of VDD in Korea, and then to evaluate the association of several factors with serum 25(OH)D level, the author analyzed the data of 14,456 individuals who were 10 years of age and over from the Fifth Korea National Health and Nutrition Examination Survey 1 & 2 (KNHANES V-1 & 2) conducted by the Korean Centers for Disease Control & Prevention. As a result, among Koreans (age ≧ 10years), 65.9% of males and 77.7% of females were below optimum blood serum 25(OH)D (20 ng/mL). VDD is more severe in female than in male at all age groups. In addition, the younger generations had less 25(OH)D level than older generations in Korea. The analysis by complex sample general linear model (CSGLM) suggested that blood 25(OH)D concentration was related with gender (p < .001), residence (p = .030), occupation (p < .001), anemia (p < .001) and physical activity (p < .001). In conclusion, VDD is pandemic and it is more severe in younger generations in Korea. Further, from the results by CSGLM, serum 25(OH)D status is closely related with the life style of Koreans.

Keywords: vitamin D; VDD; 25(OH)D; life style; KNHANES

Tables


Table 1
General characteristics for participants of KNHANES 2010-2011 (age ≥ 10 years)
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Table 2
25(OH)D concentration by several parameters in males (age ≥ 10 years)
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Table 3
25(OH)D concentration by several parameters in females (age ≥ 10 years)
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Table 4
Model effect analysis by CSGLM1)
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Table 5
Parameter estimates1) by CSGLM
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References
1. Christodoulou S, Goula T, Ververidis A, Drosos G. Vitamin D and bone disease. Biomed Res Int 2013;2013:396541.
2. Holick MF. Vitamin D deficiency. N Engl J Med 2007;357(3):266–281.
3. Bouillon R, Carmeliet G, Verlinden L, van Etten E, Verstuyf A, Luderer HF, Lieben L, Mathieu C, Demay M. Vitamin D and human health: lessons from vitamin D receptor null mice. Endocr Rev 2008;29(6):726–776.
4. Wacker M, Holick MF. Vitamin D - effects on skeletal and extraskeletal health and the need for supplementation. Nutrients 2013;5(1):111–148.
5. Pekkinen M, Viljakainen H, Saarnio E, Lamberg-Allardt C, Mäkitie O. Vitamin D is a major determinant of bone mineral density at school age. PLoS One 2012;7(7):e40090.
6. Souberbielle JC, Body JJ, Lappe JM, Plebani M, Shoenfeld Y, Wang TJ, Bischoff-Ferrari HA, Cavalier E, Ebeling PR, Fardellone P, Gandini S, Gruson D, Guérin AP, Heickendorff L, Hollis BW, Ish-Shalom S, Jean G, von Landenberg P, Largura A, Olsson T, Pierrot-Deseilligny C, Pilz S, Tincani A, Valcour A, Zittermann A. Vitamin D and musculoskeletal health, cardiovascular disease, autoimmunity and cancer: Recommendations for clinical practice. Autoimmun Rev 2010;9(11):709–715.
7. Muscogiuri G, Sorice GP, Ajjan R, Mezza T, Pilz S, Prioletta A, Scragg R, Volpe SL, Witham MD, Giaccari A. Can vitamin D deficiency cause diabetes and cardiovascular diseases? Present evidence and future perspectives. Nutr Metab Cardiovasc Dis 2012;22(2):81–87.
8. Pilz S, Tomaschitz A, März W, Drechsler C, Ritz E, Zittermann A, Cavalier E, Pieber TR, Lappe JM, Grant WB, Holick MF, Dekker JM. Vitamin D, cardiovascular disease and mortality. Clin Endocrinol (Oxf) 2011;75(5):575–584.
9. Kienreich K, Tomaschitz A, Verheyen N, Pieber T, Gaksch M, Grübler MR, Pilz S. Vitamin D and cardiovascular disease. Nutrients 2013;5(8):3005–3021.
10. Kostoglou-Athanassiou I, Athanassiou P, Lyraki A, Raftakis I, Antoniadis C. Vitamin D and rheumatoid arthritis. Ther Adv Endocrinol Metab 2012;3(6):181–187.
11. Chitsaz A, Maracy M, Basiri K, Izadi Boroujeni M, Tanhaei AP, Rahimi M, Meamar R. 25-hydroxyvitamin d and severity of Parkinson's disease. Int J Endocrinol 2013;2013:689149.
12. Crane-Godreau MA, Black CC, Giustini AJ, Dechen T, Ryu J, Jukosky JA, Lee HK, Bessette K, Ratcliffe NR, Hoopes PJ, Fiering S, Kelly JA, Leiter JC. Modeling the influence of vitamin D deficiency on cigarette smoke-induced emphysema. Front Physiol 2013;4:132.
13. Holgate ST. The epidemic of asthma and allergy. J R Soc Med 2004;97(3):103–110.
14. Kheradmand F, Rishi K, Corry DB. Environmental contributions to the allergic asthma epidemic. Environ Health Perspect 2002;110 Suppl 4:553–556.
15. Gupta D, Vashi PG, Trukova K, Lis CG, Lammersfeld CA. Prevalence of serum vitamin D deficiency and insufficiency in cancer: review of the epidemiological literature. Exp Ther Med 2011;2(2):181–193.
16. Kinder BW, Hagaman JT. Could combating vitamin D deficiency reduce the incidence of autoimmune disease. Expert Rev Clin Immunol 2011;7(3):255–257.
17. Laway BA. Vitamin D deficiency and youth-onset diabetes in North India. Arq Bras Endocrinol Metabol 2013;57(2):159–160.
18. Chakhtoura M, Azar ST. The role of vitamin D deficiency in the incidence, progression, and complications of type 1 diabetes mellitus. Int J Endocrinol 2013;2013:148673.
19. Gunville CF, Mourani PM, Ginde AA. The role of vitamin D in prevention and treatment of infection. Inflamm Allergy Drug Targets 2013;12(4):239–245.
20. Prietl B, Treiber G, Pieber TR, Amrein K. Vitamin D and immune function. Nutrients 2013;5(7):2502–2521.
21. Sadat-Ali M, Al Elq A, Al-Farhan M, Sadat NA. Fortification with vitamin D: comparative study in the Saudi Arabian and US markets. J Family Community Med 2013;20(1):49–52.
22. Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr 2008;87(4):1080S–1086S.
23. Moan J, Porojnicu AC, Dahlback A, Setlow RB. Addressing the health benefits and risks, involving vitamin D or skin cancer, of increased sun exposure. Proc Natl Acad Sci U S A 2008;105(2):668–673.
24. Gonzalez H, Tarras-Wahlberg N, Strömdahl B, Juzeniene A, Moan J, Larkö O, Rosén A, Wennberg AM. Photostability of commercial sunscreens upon sun exposure and irradiation by ultraviolet lamps. BMC Dermatol 2007;7:1.
25. Nair R, Maseeh A. Vitamin D: The "sunshine" vitamin. J Pharmacol Pharmacother 2012;3(2):118–126.
26. Visweswaran RK, Lekha H. Extraskeletal effects and manifestations of vitamin D deficiency. Indian J Endocrinol Metab 2013;17(4):602–610.
27. Hochberg Z, Templeton AR. Evolutionary perspective in skin color, vitamin D and its receptor. Hormones (Athens) 2010;9(4):307–311.
28. Guessous I, Dudler V, Glatz N, Theler JM, Zoller O, Paccaud F, Burnier M, Bochud M. Swiss Survey on Salt Group. Vitamin D levels and associated factors: a population-based study in Switzerland. Swiss Med Wkly 2012;142:w13719.
29. Choi HS, Oh HJ, Choi H, Choi WH, Kim JG, Kim KM, Kim KJ, Rhee Y, Lim SK. Vitamin D insufficiency in Korea--a greater threat to younger generation: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008. J Clin Endocrinol Metab 2011;96(3):643–651.
30. Ministry of Health and Welfare. Korea Centers for Disease Control and Prevention. Korea Health Statistics 2010: Korea National Health and Nutrition Examination Survey (KNHANES V-1). Cheongwon: Korea Centers for Disease Control and Prevention; 2011.
31. Ministry of Health and Welfare. Korea Centers for Disease Control and Prevention. Korea Health Statistics 2011: Korea National Health and Nutrition Examination Survey (KNHANES V-2). Cheongwon: Korea Centers for Disease Control and Prevention; 2012.
32. Weisman Y. Vitamin D deficiency and insufficiency. Isr Med Assoc J 2013;15(7):377–378.
33. Haddad JG Jr, Rojanasathit S. Acute administration of 25-hydroxycholecalciferol in man. J Clin Endocrinol Metab 1976;42(2):284–290.
34. Stamp TC, Round JM, Rowe DJ, Haddad JG. Plasma levels and therapeutic effect of 25-hydroxycholecalciferol in epileptic patients taking anticonvulsant drugs. Br Med J 1972;4(5831):9–12.
35. Birge SJ, Haddad JG. 25-hydroxycholecalciferol stimulation of muscle metabolism. J Clin Invest 1975;56(5):1100–1107.
36. Thacher TD, Clarke BL. Vitamin D insufficiency. Mayo Clin Proc 2011;86(1):50–60.
37. Naugler C, Zhang J, Henne D, Woods P, Hemmelgarn BR. Association of vitamin D status with socio-demographic factors in Calgary, Alberta: an ecological study using Census Canada data. BMC Public Health 2013;13:316.
38. 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):4125–4130.
39. Sulistyoningrum DC, Green TJ, Lear SA, Devlin AM. Ethnic-specific differences in vitamin D status is associated with adiposity. PLoS One 2012;7(8):e43159.
40. Sacheck J, Goodman E, Chui K, Chomitz V, Must A, Economos C. Vitamin D deficiency, adiposity, and cardiometabolic risk in urban schoolchildren. J Pediatr 2011;159(6):945–950.
41. Rajakumar K, de las Heras J, Chen TC, Lee S, Holick MF, Arslanian SA. Vitamin D status, adiposity, and lipids in black American and Caucasian children. J Clin Endocrinol Metab 2011;96(5):1560–1567.
42. Khor GL, Chee WS, Shariff ZM, Poh BK, Arumugam M, Rahman JA, Theobald HE. High prevalence of vitamin D insufficiency and its association with BMI-for-age among primary school children in Kuala Lumpur, Malaysia. BMC Public Health 2011;11:95.
43. Shahar DR, Schwarzfuchs D, Fraser D, Vardi H, Thiery J, Fiedler GM, Blüher M, Stumvoll M, Stampfer MJ, Shai I. DIRECT Group. Dairy calcium intake, serum vitamin D, and successful weight loss. Am J Clin Nutr 2010;92(5):1017–1022.
44. Tzotzas T, Papadopoulou FG, Tziomalos K, Karras S, Gastaris K, Perros P, Krassas GE. Rising serum 25-hydroxy-vitamin D levels after weight loss in obese women correlate with improvement in insulin resistance. J Clin Endocrinol Metab 2010;95(9):4251–4257.
45. Lagunova Z, Porojnicu AC, Lindberg F, Hexeberg S, Moan J. The dependency of vitamin D status on body mass index, gender, age and season. Anticancer Res 2009;29(9):3713–3720.
46. Parikh SJ, Edelman M, Uwaifo GI, Freedman RJ, Semega-Janneh M, Reynolds J, Yanovski JA. The relationship between obesity and serum 1,25-dihydroxy vitamin D concentrations in healthy adults. J Clin Endocrinol Metab 2004;89(3):1196–1199.
47. Absoud M, Cummins C, Lim MJ, Wassmer E, Shaw N. Prevalence and predictors of vitamin D insufficiency in children: a Great Britain population based study. PLoS One 2011;6(7):e22179.
48. Shirazi L, Almquist M, Malm J, Wirfält E, Manjer J. Determinants of serum levels of vitamin D: a study of life-style, menopausal status, dietary intake, serum calcium, and PTH. BMC Womens Health 2013;13(1):33.