Prevalence of low 25 OH-Vitamin D levels in Costa Rican university students

Authors

DOI:

https://doi.org/10.51481/amc.v65i3.1292

Keywords:

Vitamin D, insulin resistance, Vitamin D defficiency, hy´perinsulinism, Costa Rica

Abstract

Objective: To determine the prevalence of hypovitaminosis D3 in a population of Costa Rican University students and describe its clinical and biochemical characteristics.

Methods: Cross-sectional and descriptive research with a total of 118 healthy individuals of both genders aged between 18-43 years. Questions were asked about family historyof chronic diseases, level of sun exposure, use of sunscreens, blood pressure. In the laboratory, glucose, calcium, phosphate, parathyroid hormone, insulin, 25 OH-Vitamin D and immunoglobulin E were analyzed in serum. Body Mass Index and the mathematical assessment model for the homeostasis of insulin resistance were calculated.

Results: The prevalence of hypovitaminosis D3 (<30 ng/mL) in this study was 25% with no significant difference by sex. The average concentration of 25 OH-Vitamin D was 36.2 ng/mL, with values ranging from 14.5 to 59.5 ng/mL. A total of 26 students had 25 OHVitamin D insufficiency (21-29 ng/mL) and only 4 were classified as severely deficient (<20 ng/mL). No cases of hypervitaminosis D3 (> 100 ng/mL) were found in the study sample. When comparing those subjects with 25 OH-Vitamin D3 deficiency against those with normal serum levels of this vitamin, significant differences were observed only in two biochemical parameters: insulin (10.9 ± 7.4 μIU/mL vs 8.3 ± 4.1 μUI/mL; p=0.017) and the HOMA IR index (2.48 ± 1.86 vs 1.85 ± 0.3; p=0.002). Nearly half of the students reported a family history of Diabetes Mellitus (49.2%) and arterial hypertension (52.9%). Near 29% of the participants were overweight and obese.

Conclusions: Around 25% of the subjects studied presented 25 OH-Vitamin D deficiency. These subjects, in turn, presented a higher prevalence of hyperinsulinemia and insulin resistance compared with people with normal concentrations of this vitamin. There is also a high prevalence of risk factors among the relatives of the young population that could increase the risk of these students of suffering from Diabetes Mellitus or cardiovascular diseases in the future.

Downloads

Download data is not yet available.

Author Biographies

  • Nelly Castro-Bonilla, Universidad de Costa Rica

    University of Costa Rica, Faculty of Microbiology, San Pedro Montes de Oca

  • Cynthia Arroyo-Portilla, Universidad de Costa Rica

    Universidad de Costa Rica, Facultad de Microbiología, San Pedro Montes de Oca

     

  • Juan Manuel Valverde-Barrantes, Universidad de Costa Rica

    University of Costa Rica, Faculty of Microbiology, San Pedro Montes de Oca 

  • Marco Vargas-Soto, Clinical Laboratory of the Office of Welfare and Health
    Clinical Laboratory of the Office of Welfare and Health
  • Mauro Barrantes- Santamaría, Laboratorio Clínico Referencia
    Clinical Reference Laboratory, Dominican Republic

References

-Bikle D. Vitamin D metabolism, mechanism of action, and clinical applications. Chem Biol. 2014; 21: 319-329. DOI:10.1016/j.chembiol.2013.12.016

-Zuluaga N, Alfaro J, Balthazar V, Jiménez K, Campuzano G. Vitamina D: nuevos paradigmas. Medicina y Laboratorio. 2011; 17: 211-246.

-Bikle D. Nonclassic Actions of Vitamin D. J Clin Endocrinol Metab. 2009; 94:26-34. DOI: 10.1210/jc.2008-1454.

-Giovannucci E, Lui Y, Hollis BW, Rimm E.B. A prospective study of 25- Hidroxy-Vitamin D and Risk of Myocardial Infarction in Men. Arch Intern Med. 2008; 168:1174-1180. DOI: 10.1001/archinte.168.11.1174

- Adams JS, Hewison M. Update in Vitamin D. Clin Endocrinol Metab. 2010; 95:471-478.DOI: 10.1210/jc.2009-1773

- Solano M, Vargas M, Brenes A, Holst I. Prevalence of Vitamin D deficiency in Costa Rican Children. Acta méd.costarric. 2021; 63:104-112. DOI: 10.51481/amc.v63i2.1110

-Chen CH, Jiménez M, Ulate L. Hipovitaminosis D en Costa Rica, reporte incial. Estudio de casos y controles. Acta méd.costarric. 2012; 54, 146-151.

- Gamboa T, Abarca G, Jiménez JG. Prevalence of 25-hydroxyvitamin D deficiency in healthy personnel from an academic institution of an urban area in Costa Rica. Research and Reports in Endocrine Disorders. 2015; 5 : 135-140 DOI: 10.2147/RRED.S90435.

- Kabadi S, Lee BK, L. Joint Effects of Obesity and Vitamin D Insufficiency on Insulin Resistance and Type 2 Diabetes. Diabetes Care.2012; 35:2048-2054. DOI: 10.2337/dc12-0235

- Kelishadi R, Salek S, Salek M, Hashemipour M, Movahedian M. Effects of vitamin D supplementation on insulin resistance and cardiometabolic risk factors in children with metabolic syndrome: a triple-masked controlled trial. J Pediatr. 2014; 90:28-34. DOI: 10.1016/j.jped.2013.06.006.

- Al-Khalidi B, Kimball SM, Rotondi MA, Ardern CI. Standardized serum 25-hydroxyvitamin D concentrations are inversely associated with cardiometabolic disease in U.S.adults: a cross-sectional analysis of NHANES, 2001-2010. Nutr J. 2017; 16: 16. DOI: 10.1186/s12937-017-0237-6

-Papandreou D, Hamid ZT. The role of vitamin D in diabetes and cardiovascular disease: an updated review of the literature. Dis Markers. 2015; 1-15. DOI: 10.1155/2015/580474.

- Seida JC, Mitri J, Colmers IN, Majumdar SR, Davidson MB, Edwards AL, et al. Clinical review: effect of vitamin D3 supplementation on improving glucose homeostasis and preventing diabetes: a systematic review and metaanalysis. J Clin Endocrinol Metab. 2014; 99:3551-3560. DOI: 10.1210/jc.2014-2136.

- Madrigal J. La construcción de índices. San José: Editorial UCR, Universidad de Costa Rica; 1997 15- Barlow SE, Expert Committee. Expert Committee recomendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007; 120: S164-192. DOI: 10.1542/peds.2007-2329C

- Garmendia ML, Lera L, Sánchez H, Uauy R, Albala C. Valores normativos de resistencia a la insulina mediante HOMA-IR en adultos mayores de Santiago de Chile. Rev. méd.Chile. 2009; 137:1409-1416. DOI: 10.4067/S0034-98872009001100001

- Buccini G, Wolfthal D. Valores de corte para índices de insulinorresistencia, insulinosensibilidad e insulinosecreción derivados de la fórmula HOMA-IR y del programa HOMA 2. Interpretación de datos. 15-RAEM. 2008; 45:3-21.

- Busturia MA. Vitamina D: visión desde el laboratorio. Rev Esp Endocrinol Pediatr. 2012; 3:39-45. DOI: 10.3266/RevEspEndocrinolPediatr.pre2012.Apr.99

- Qu HQ, Li Q, Rentfro A, Fisher S, McCormick JB. The definition of insulin resistance using HOMA-IR for americans of mexican descent using machine learning. PLoS ONE. 2011; 6: e21041. DOI: 10.1371/journal.pone.0021041

- Brandan N, Llanos I, Rodríguez A. Regulación hormonal del balace fosfocálcico. Universidad Nacional del Nordeste. Facultad de Medicina. Cátedra de Bioquímica. 2012; 1:1-16.

- Jódar E, Muñoz M. Sistema hormonal D y diabetes mellitus: lecciones de los activadores selectivos del receptor de vitamina D. Endocrinol Nutr. 2013; 60:87-95. DOI: 10.1016/j.endonu.2012.04.005

- Lips P and van Schoor N. The effecct to vitamin D on bone and osteoporosis. Best Pract Res Clin Endocrinol Metab. 2011; 25:585-591. DOI: 10.1016/j.beem.2011.05.002.

-Thacer T, Clarke B. Vitamin D Insufficiency. Mayo Clin Proc. 2011; 86:50-60. DOI: 10.4065/mcp.2010.0567

- Wacker M, Holick MF. Sunlight and Vitamin D: a global perspective for health. Dermatoendocrinol. 2013; 5:51-108. DOI: 10.4161/derm.24494.

- Norval M, Wulf HC. Does chronic sunscreen use reduce vitamin D production to insufficient levels? BJD. 2009; 161:732-736. DOI: 10.1111/j.1365-2133.2009.09332.x.

- Mazanova A, Shymanskyi I, Lisakovska O, Hajiyeva L, Komisarenko Y, Veliky M. Effects of Cholecalciferol on Key Components of Vitamin D-Endo/Para/Autocrine System in Experimental Type 1 Diabetes. Int J Endocrinol. 2018; 1-9. DOI: 10.1155/2018/2494016

-Talaei A, Mohamadi M and Adgi Z. The effect of vitamin D on insulin resistence in patients with type 2 diabetes. Diabetology and Metabolic Syndrome. 2013; 5:8. DOI: 10.1186/1758-5996-5-8

- Angellotti E, Pittas AG. The role of vitamin D in the prevention of type 2 diabetes: to D or not to D?. Endocrinology. 2017; 158:2013-2021. DOI: 10.1210/en.2017-00265

-Lee CJ, Lyer G, Liu Y, Kalyani RR, Bamba ND, Ligon CB, et al. The effect of vitamin D supplementation on glucose metabolism in type 2 diabetes mellitus: a systematic review and meta-analysis of intervention studies. J Diabetes Complications. 2017; 31:1115-1126. DOI: 10.1016/j.jdiacomp.2017.04.019

- Agarwal Charu Marwah, Sadhna Kulshrestha, Bindu Anubhuti. Effect of Vitamin D Replacement Therapy on Glycaemic Control in Type 2 Diabetic Mellitus Patients. Journal of Clinical and Diagnostic Research. 2017; 11:40-43. DOI: 10.7860/JCDR/2017/29371.11009

-Wu C, Qiu S, Zhu X, Li L. Vitamin D supplementation and glycemic control in type 2 diabetes patients: a systematic review and meta-analysis. Metabolism. 2017; 73:67-76. DOI: 10.1016/j.metabol.2017.05.006

- Sharifi F, Mousavinasab N, Mellati A. Defining a cutoff point for vitamin D deficiency based on insulin resistance in children. Diabetes Metab Syndr. 2013; 7:210-213. DOI: 10.1016/j.dsx.2013.10.015

- Durmaz ZH, Demir AD, Ozkan T, Kılınç Ç, Güçkan R, Tiryaki M. Does vitamin D deficiency lead to insulin resistance in obese individuals? Biomedical Res. 2017; 28:7491-7497.

-Querales MI, Cruces ME, Rojas S, Sánchez L. Deficiencia de vitamina D: ¿Factor de riesgo de síndrome metabólico? Rev Med Chile. 2010; 138:1312-1318. DOI: 10.4067/S0034-98872010001100017

-Botella J, Alvarez F, Villafruela J, Blasa J, Vázquez C, Escobar H. Vitamin D deficiency is associated with the metabolic syndrome in morbid obesity. Clin Nutr. 2007; 26(5):573-580. DOI: 10.1016/j.clnu.2007.05.009.

- Brehm J, Celedón J, Soto-Quiros M, Avila L, Hunningjake G, Forno E et al. Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica. Am J Respir Crit Care Med. 2009; 179:765-771. DOI:10.1164/rccm.200808-1361OC

-Cheng H M, Kim S, Park G, Chang S, Bang S, Won C, et al. Low vitamin D levels are associated with atopic dermatitis, but not allergic rhinitis, asthma, or IgE sensitization, in the adult Korean population. J Allergy Clin Immunol. 2014; 133:1048-1055. DOI: 10.1016/j.jaci.2013.10.055

- Holick MF. The vitamin D deficiency pandemic: approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord. 2017; 18:153-165. DOI: 10.1007/s11154-017-9424-1

- Vanchinathan V, Lim H. A Dermatologist's Perspective on Vitamin D. Mayo Clin Proc. 2012; 87:372-380. DOI: 10.1016/j.mayocp.2011.12.010

- Randhawa FA, Mustafa S, Khan DM, Hamid S. Effect of Vitamin D supplementation on reduction in levels of HbA1 in patients recently diagnosed with type 2 Diabetes Mellitus having asymptomatic Vitamin D deficiency. Pak J Med Sci. 2017; 33:881-885. DOI: 10.12669/pjms.334.12288

Downloads

Published

2023-09-29

Issue

Vol. 65 No. 3 (2023): Acta Médica Costarricense July-September

Section

Original

License

Copyright (c) 2023 Acta Médica Costarricense

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Los autores que publican en la revista Acta Médica Costarricense pueden distribuir, copiar, remezclar, retocar, leer, descargar, imprimir, buscar y crear a partir de su obra de modo no comercial, indicando los créditos a la revista y sus autores y compartir su obra en las mismas condiciones. Para ello se aplica la licencia Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional(CC BY-NC-SA 4.0)

How to Cite

Prevalence of low 25 OH-Vitamin D levels in Costa Rican university students. (2023). Acta Médica Costarricense , 65(3), 1-10. https://doi.org/10.51481/amc.v65i3.1292