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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 10  |  Issue : 1  |  Page : 14-17

Epidemiological study of Vitamin D deficiency among Libyan patients


1 Department of Anesthesia and Intensive Care, Faculty of Medical Technology, The University of Tripoli, Tripoli, Libya
2 Department of Medical Laboratories, University of Tripoli Alahlia, Janzur, Libya

Date of Submission04-Jun-2021
Date of Decision11-Jul-2021
Date of Acceptance13-Sep-2021
Date of Web Publication10-Feb-2022

Correspondence Address:
Dr. Ahmed Atia
Department of Anesthesia and Intensive Care, Faculty of Medical Technology, The University of Tripoli, Tripoli
Libya
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjhs.mjhs_39_21

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  Abstract 


Background: Vitamin D deficiency (VDD) is not only common globally but is more rampant in Libya. Assessment and management of it can help prevent many other conditions and serious diseases. Objective: This stuay aimed to study the prevalence of VDD among patients attending private clinics in Zawia city of Libya.
Methods: A Cross-sectional study was carried out among 71 apparently healthy patients from different private clinics laboratory, Zawia city, Libya. After obtaining informed consent and confirming the willingness of the patients to give the blood samples, the data were recorded in the pre-designed, pre-tested, and semi-structured study questionnaire. Variables such as age and sex were recorded. Vitamin D status was ascertained for all included participants in the present study.
Results: Female participants were more than male participants in the present study (63.4% vs. 36.6%). Majority (45.1%) belonged to the age group of 41–64 years followed by 1–18 years of age (39.4%). The mean value of Vitamin D among females (19.8 ± 2 nmol/L) was significantly lower when compared to males (25.7 ± 3 nmol/L). The mean value of Vitamin D was significantly lower in the age group of 41–64 years and more than 64 years of age compared to 1–40 years of age (P < 0.05).
Conclusion: The prevalence of VDD was more in females compared to males. The values decreased with increasing age.

Keywords: 25(OH) Vitamin D, sunlight, Vitamin D deficiency


How to cite this article:
Atia A, Arhoma S. Epidemiological study of Vitamin D deficiency among Libyan patients. MRIMS J Health Sci 2022;10:14-7

How to cite this URL:
Atia A, Arhoma S. Epidemiological study of Vitamin D deficiency among Libyan patients. MRIMS J Health Sci [serial online] 2022 [cited 2023 Feb 3];10:14-7. Available from: http://www.mrimsjournal.com/text.asp?2022/10/1/14/337523




  Introduction Top


One of the fat-soluble vitamins is Vitamin D. It possesses antirachitic activities. When we use the term Vitamin D, it usually means Vitamin D3. Our body skin with the help of sunlight synthesizes Vitamin D which constitutes about 90% of the total requirement of the body. Vitamin D is indispensable for serum phosphate and calcium levels in the body. Thus, it indirectly contributes to the overall well-being of the body functions. It also plays an important role in immunity, proliferation, and differentiation of cells. Thus, Vitamin D is an important component needed by the human body.[1],[2]

Globally, deficiency of Vitamin D is very common. As we understand the role and functions of Vitamin D, it is not hard to say that its deficiency causes a number of problems in the body like it affects the development of the bones. Vitamin D deficient people are prone to develop diseases such as diabetes, cancer, and autoimmune diseases. The overall estimated prevalence of Vitamin D deficiency (VDD) is said to be around 30%–50%. Even it is more common in those areas where the climate is mostly sunny and there is no lack of sunlight.[3],[4]

The World Health Organization categorized Libya as a country “in complex emergency situation” as the prevalence of undernutrition among mothers and children is high and at the same time, most people have deficiencies of micronutrients.[5] Among this, VDD has been reported to be a common public health problem not only from Libya but also from the entire region of “Near East and North Africa.” There is a lack of facilities such as monitoring, supervision, and evaluation of nutritional status of the population. This disables the implementation of the new policies. Due to this, it is not easy to address this issue at large scale.[6]

With this background, the present study was undertaken to study the prevalence of VDD among patients attending private clinics in Zawia city of Libya.


  Methods Top


Study design

This was a cross-sectional study.

Study period

The study period was from June 1, 2020, to August 20, 2020

Settings

Apparently healthy patients from different private clinics laboratory, Zawia city, Libya.

Sample size and sampling technique

During the study period, it was possible to include 71 patients who attended the different private clinics’ laboratories in Zawia City from Libya. These patients were enrolled in the study using a convenient sampling technique.

Ethical considerations

The study was conducted according to the guidelines of the Declaration of Helsinki and all procedures were approved by the Ethical Committee of the University of Tripoli Alahlia, Tripoli, Libya. Informed consent was obtained from the study participants.

Inclusion criteria

  1. Apparently healthy persons attending different private clinics laboratories in Zawia City from Libya of all age groups and either gender
  2. Willing to participate in the present study.


Exclusion criteria

  1. Patients with known comorbidities
  2. Patients not willing to give blood samples.


After obtaining informed consent and confirming the willingness of the patients to give the blood samples, the data were recorded in the pre-designed, pre-tested, and semi-structured study questionnaire. Variables such as age and sex were recorded. Vitamin D status was ascertained for all included participants in the present study.

Vitamin D status assessment

Venous blood samples were taken from 71 randomly selected women who participated in the survey after they had fasted for 12 hours. The serum 25 (OH)D was measured using a Roche Diagnostics Cobas e411 analyzer and an electrochemiluminescence protein binding assay (ECLIA). Vitamin D status was analyzed according to cut-off values; deficient (25(OH)D level <30 nmol/l), inadequate (25(OH)D level between 30 and 50 nmol/l), sufficient (25(OH)D level >50 nmol/l).

Statistical analysis

Numbers and percentages were used to represent the variables. Student's t-test was used to present quantitative variables as mean ± standard deviation for two groups and for more than two groups, ANOVA was used to calculate the f value. P < 0.05 was deemed statistically important when testing the magnitude of difference for quantitative variables.


  Results Top


Female participants were more than male participants in the present study (63.4% vs. 36.6%). Majority (45.1%) belonged to the age group of 41–64 years followed by 1–18 years of age (39.4%) [Table 1].
Table 1: Demographic characteristics

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The mean value of Vitamin D among females (19.8 ± 2 nmol/L) was significantly lower when compared to males (25.7 ± 3 nmol/L) [Table 2].
Table 2: Association between gender and Vitamin D status

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The mean value of Vitamin D was significantly lower in the age group of 41–64 years and more than 64 years of age compared to 1–40 years of age (P < 0.05) [Table 3].
Table 3: Association between age and Vitamin D status

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  Discussion Top


VDD, particularly in children and women, has become a major public health concern in all countries.[7] Understanding the scope of the issue, as well as the development and implementation of policies and actions to eradicate VDD, is hampered by a lack of multiple data on Vitamin D status and intake in the area.[8],[9]

Our findings indicated that the level of Vitamin D was low among female patients. In our sample, the mean Vitamin D status of females was 19.8 2 nmol/L, while it was 25.7 3 nmol/L for males. In comparison to 52%of male participants, 79.4% of women (79.4%) had Vitamin D levels below 20 nmol/L.

This research in line with previous local studies, which reported that a concentration of ≤10 ng/mL of serum 25(OH) D is considered as the indicator of severe VDD. [7,10-12] In our study, elderly participants had the lowest Vitamin D intake (17.0 ± 2 nmol/L), followed by patients aged 41–64 years (22.1 ± 4 nmol/L), adolescence and young adults aged 19–40 years (27.7 ± 2 nmol/L), and children (32.6 ± 1 nmol/L).

Due to the outdoor traditional dressing for women in Arabian countries, which involves covering all body parts except the face and hands or all body parts except the face and hands, the association of 25(OH) D deficiency and female gender is normal. Females wearing hijab (uncovered face and hands) or niqab (i.e., covering their whole body) in Libya have lower 25(OH) D serum levels than their western-style-dressed counterparts, as previously reported.[13]

VDD and its role in maintaining optimum health are becoming more widely recognized.[14] Vitamin D's importance in calcium absorption and metabolism for bone health is well established. Furthermore, the function of Vitamin D in reducing the risk of cancer, multiple sclerosis, and type 1 diabetes mellitus has been studied for the past two decades.[15] In the last decade, there have been numerous reviews and discussions on the importance of Vitamin D in disease prevention and optimal health maintenance. As a result, the role of VDD in preventing chronic diseases and sustaining health has been recognized over the life cycle.[16]

The study's limitations include the limited number of study groups conducted, particularly early in the year. We are unable to comment on seasonal change and its effect on Vitamin D levels because the research was not performed during the year.


  Conclusion Top


The prevalence of VDD was more in females compared to males. The values decreased with increasing age.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Holick MF. Vitamin D: A millenium perspective. J Cell Biochem 2003;88:296-307.  Back to cited text no. 1
    
2.
Holick MF. The Vitamin D epidemic and its health consequences. J Nutr 2005;135:2739S-48S.  Back to cited text no. 2
    
3.
Thomas MK, Lloyd-Jones DM, Thadhani RI, Shaw AC, Deraska DJ, Kitch BT, et al. Hypovitaminosis D in medical inpatients. N Engl J Med 1998;338:777-83.  Back to cited text no. 3
    
4.
Chapuy MC, Preziosi P, Maamer M, Arnaud S, Galan P, Hercberg S, et al. Prevalence of Vitamin D insufficiency in an adult normal population. Osteoporos Int 1997;7:439-43.  Back to cited text no. 4
    
5.
World Health Organization. Regional Office for the Eastern Mediterranean. (2011). Regional strategy on nutrition 2010–2019 and plan of action. https://apps.who.int/iris/handle/10665/116694.  Back to cited text no. 5
    
6.
El Taguri A. Essential concepts in modern health services. Libyan J Med 2008;3:148-55.  Back to cited text no. 6
    
7.
Faid F, Nikolic M, Milesevic J, Zekovic M, Kadvan A, Gurinovic M, et al. Assessment of Vitamin D intake among Libyan women – Adaptation and validation of specific food frequency questionnaire. Libyan J Med 2018;13:1-9.  Back to cited text no. 7
    
8.
Bassil D, Rahme M, Hoteit M, Fuleihan Gel-H. Hypovitaminosis D in the middle East and North Africa: Prevalence, risk factors and impact on outcomes. Dermatoendocrinol 2013;5:274-98.  Back to cited text no. 8
    
9.
Djekic-Ivankovic M, Weiler HA, Nikolic M, Kadvan A, Gurinovic M, Mandic LM, et al. Validity of an FFQ assessing the Vitamin D intake of young Serbian women living in a region without food fortification: The method of triads model. Public Health Nutr 2016;19:437-45.  Back to cited text no. 9
    
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Benhamed M, Marwan A, Dekna M, Ahmad A. Vitamin D levels and rickets indices among infants and their nursing mothers in Tripoli – Libya. Libyan J Agric 2017;22:47-60.  Back to cited text no. 10
    
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Omar M, Nouh F, Younis M, Nabil N, Saad M, Ali M. Vitamin D status and contributing factors in patients attending three polyclinics in Benghazi Libya. J Adv Med Med Res 2017;24:1-13.  Back to cited text no. 11
    
12.
Omar M, Nouh F, Younis M, Nabil N, Saad M, Ali M. Culture, sun exposure and Vitamin D deficiency in Benghazi Libya. J Adv Med Med Res 2018;25:1-13.  Back to cited text no. 12
    
13.
Al-Graiw MH, Draid MM, Zaidi AM, Al-Griw HH. Serum Vitamin D levels and associated risk factors among Libyan females living in Tripoli, Libya: A cross-sectional study. Libyan J Med Sci 2020;4:169-73.  Back to cited text no. 13
  [Full text]  
14.
Alshishtawy MM. Vitamin D deficiency: This clandestine endemic disease is veiled no more. Sultan Qaboos Univ Med J 2012;12:140-52.  Back to cited text no. 14
    
15.
Harandi AA, Harandi AA, Pakdaman H, Sahraian MA. Vitamin D and multiple sclerosis. Iran J Neurol 2014;13:1-6.  Back to cited text no. 15
    
16.
Heaney RP. Vitamin D in health and disease. Clin J Am Soc Nephrol 2008;3:1535-41.  Back to cited text no. 16
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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