DOI QR코드

DOI QR Code

Prevalence of vitamin D deficiency in Korea: Results from KNHANES 2010 to 2011

한국인의 비타민 D 부족 유병률에 관한 연구: 국민건강영양조사 2010~2011 분석결과

  • Received : 2013.09.23
  • Accepted : 2013.11.20
  • Published : 2013.12.31

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 $${\geq_-}$$ 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

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 https://doi.org/10.1056/NEJMra070553
  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 https://doi.org/10.1210/er.2008-0004
  4. Wacker M, Holick MF. Vitamin D - effects on skeletal and extraskeletal health and the need for supplementation. Nutrients 2013; 5(1): 111-148 https://doi.org/10.3390/nu5010111
  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 https://doi.org/10.1371/journal.pone.0040090
  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 https://doi.org/10.1016/j.autrev.2010.06.009
  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 https://doi.org/10.1016/j.numecd.2011.11.001
  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 https://doi.org/10.1111/j.1365-2265.2011.04147.x
  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 https://doi.org/10.3390/nu5083005
  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 https://doi.org/10.1177/2042018812471070
  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 https://doi.org/10.1258/jrsm.97.3.103
  14. Kheradmand F, Rishi K, Corry DB. Environmental contributions to the allergic asthma epidemic. Environ Health Perspect 2002; 110 Suppl 4: 553-556 https://doi.org/10.1289/ehp.02110s4553
  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 https://doi.org/10.1586/eci.11.12
  17. Laway BA. Vitamin D deficiency and youth-onset diabetes in North India. Arq Bras Endocrinol Metabol 2013; 57(2): 159-160 https://doi.org/10.1590/S0004-27302013000200012
  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 https://doi.org/10.2174/18715281113129990046
  20. Prietl B, Treiber G, Pieber TR, Amrein K. Vitamin D and immune function. Nutrients 2013; 5(7): 2502-2521 https://doi.org/10.3390/nu5072502
  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 https://doi.org/10.4103/2230-8229.108186
  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 https://doi.org/10.1073/pnas.0710615105
  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 https://doi.org/10.1186/1471-5945-7-1
  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 https://doi.org/10.4103/2230-8210.113750
  27. Hochberg Z, Templeton AR. Evolutionary perspective in skin color, vitamin D and its receptor. Hormones (Athens) 2010; 9(4): 307-311 https://doi.org/10.14310/horm.2002.1281
  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 https://doi.org/10.1210/jc.2010-2133
  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 https://doi.org/10.1210/jcem-42-2-284
  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 https://doi.org/10.1136/bmj.4.5831.9
  35. Birge SJ, Haddad JG. 25-hydroxycholecalciferol stimulation of muscle metabolism. J Clin Invest 1975; 56(5): 1100-1107 https://doi.org/10.1172/JCI108184
  36. Thacher TD, Clarke BL. Vitamin D insufficiency. Mayo Clin Proc 2011; 86(1): 50-60 https://doi.org/10.4065/mcp.2010.0567
  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 https://doi.org/10.1186/1471-2458-13-316
  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. Ethnicspecific differences in vitamin D status is associated with adiposity. PLoS One 2012; 7(8): e43159 https://doi.org/10.1371/journal.pone.0043159
  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 https://doi.org/10.1016/j.jpeds.2011.06.001
  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 https://doi.org/10.1210/jc.2010-2388
  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 https://doi.org/10.1186/1471-2458-11-95
  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 https://doi.org/10.3945/ajcn.2010.29355
  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 https://doi.org/10.1210/jc.2010-0757
  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 https://doi.org/10.1210/jc.2003-031398
  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 https://doi.org/10.1371/journal.pone.0022179
  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 https://doi.org/10.1186/1472-6874-13-33

Cited by

  1. Comparative Analysis of the Effect of Physical Activity and Stress Experience on the Vitamin D Deficiency according to Occupations: results from KNHANES dataset for 2008~2013 vol.15, pp.8, 2015, https://doi.org/10.5392/JKCA.2015.15.08.505
  2. Association between serum vitamin D and depressive symptoms among female workers in the manufacturing industry vol.27, pp.1, 2015, https://doi.org/10.1186/s40557-015-0083-y
  3. Vitamin D Deficiency in Nursing Home Elderly in Korea vol.20, pp.2, 2016, https://doi.org/10.4235/jkgs.2016.20.2.102
  4. Relationship between homeostasis model assessment of insulin resistance and beta cell function and serum 25-hydroxyvitamin D in non-diabetic Korean adults vol.59, pp.2, 2016, https://doi.org/10.3164/jcbn.15-143
  5. Gender difference in relationship between serum ferritin and 25-hydroxyvitamin D in Korean adults vol.12, pp.5, 2017, https://doi.org/10.1371/journal.pone.0177722
  6. Association of Serum 25-hydroxy-vitamin D Concentration and Arterial Stiffness among Korean Adults in Single Center vol.24, pp.1, 2017, https://doi.org/10.11005/jbm.2017.24.1.51
  7. The Effect of Vitamin D and Calcium on Cognitive Function and Depression in the Elderly Living in a City vol.28, pp.3, 2017, https://doi.org/10.12799/jkachn.2017.28.3.251
  8. The relationship between serum vitamin D levels and sleep quality in fixed day indoor field workers in the electronics manufacturing industry in Korea vol.29, pp.1, 2017, https://doi.org/10.1186/s40557-017-0187-7
  9. A comparative analysis of maternal and fetal 25-hydroxyvitamin D in pregnant women with and without gestational diabetes mellitus pp.1476-4954, 2017, https://doi.org/10.1080/14767058.2017.1355899
  10. Relationship between serum 25-hydroxyvitamin D and chronic obstructive pulmonary disease in males in the fifth Korean national health and nutrition examination survey vol.47, pp.5, 2014, https://doi.org/10.4163/jnh.2014.47.5.321
  11. Relationship of vitamin D status and obesity index in Korean women vol.49, pp.1, 2016, https://doi.org/10.4163/jnh.2016.49.1.28
  12. Survey on utilization and demand for national food composition database vol.51, pp.2, 2018, https://doi.org/10.4163/jnh.2018.51.2.186
  13. 목이버섯과 흑미를 첨가한 즉석죽의 품질 특성 vol.28, pp.3, 2015, https://doi.org/10.9799/ksfan.2015.28.3.428
  14. 한국 성인 남녀에서 당뇨병 유병률과 혈중 비타민 D 농도와의 관련성 : 제6기 국민건강영양조사(2013~2014)에 근거하여 vol.23, pp.1, 2013, https://doi.org/10.14373/jkda.2017.23.1.39
  15. 한국 성인의 비타민 D 수준과 이상지질혈증과의 관련성 - 제 6기(2013년, 2014년) 국민건강영양조사 자료를 이용하여 vol.18, pp.3, 2013, https://doi.org/10.5762/kais.2017.18.3.647
  16. 건강검진 수검자에서 혈청 Vitamin D 수준과 인슐린저항성 및 β-세포 기능과의 관련성 vol.43, pp.1, 2013, https://doi.org/10.5393/jamch.2018.43.1.018
  17. 한국 20대의 비타민 D 결핍 관련요인 분석 : 제 5기 국민건강영양조사를 이용하여 vol.19, pp.5, 2018, https://doi.org/10.5762/kais.2018.19.5.303
  18. Borderline high serum calcium levels are associated with arterial stiffness and 10‐year cardiovascular disease risk determined by Framingham risk score vol.21, pp.5, 2013, https://doi.org/10.1111/jch.13532
  19. Preventive Effects of Low Parathyroid Hormone Levels on Hip Fracture in Patients with Vitamin D Deficiency vol.26, pp.2, 2013, https://doi.org/10.11005/jbm.2019.26.2.89
  20. 농촌 지역에 거주하는 한국 노인의 혈청 비타민 D 농도와 인지기능과의 상관성 vol.52, pp.5, 2013, https://doi.org/10.4163/jnh.2019.52.5.465
  21. Relationship between occupational sunlight exposure and the incidence of renal cancer vol.31, pp.1, 2013, https://doi.org/10.35371/aoem.2019.31.e32
  22. A Fusion Study on the Relationship between Lifestyle and Vitamin D Deficiency in Korean Adults vol.10, pp.12, 2013, https://doi.org/10.15207/jkcs.2019.10.12.159
  23. 여자 청소년 및 젊은 여성의 비타민 D 결핍과 빈혈과의 연관성 분석 vol.52, pp.6, 2019, https://doi.org/10.4163/jnh.2019.52.6.552
  24. Associations of 25-Hydroxyvitamin D Levels and Arthritis with Sleep Duration: The Korean National Health and Nutrition Examination Survey 2008–2014 vol.12, pp.None, 2013, https://doi.org/10.2147/nss.s275464
  25. Vitamin D deficiency and suicidal ideation: A cross-sectional study of 157,211 healthy adults vol.134, pp.None, 2013, https://doi.org/10.1016/j.jpsychores.2020.110125
  26. 비만과 고도비만 한국 여성의 혈청 페리틴과 비타민 D 수준의 비교 vol.53, pp.4, 2013, https://doi.org/10.4163/jnh.2020.53.4.381
  27. Association between serum vitamin D and depressive symptoms in apparently healthy male adults undergoing routine health check-ups at a single centre vol.23, pp.14, 2020, https://doi.org/10.1017/s1368980020000592