Kütahya İli D Vitamini Düzeylerinin Değerlendirilmesi: Hastane Bazlı Retrospektif Çalışma

Year 2023, Volume: 5 Issue: 3, 164 - 170, 01.11.2023

Özlem Arık , İnci Arıkan , Türkan Paşalı Kilit , Havva Koçak

https://doi.org/10.38175/phnx.1259661

Abstract

Amaç: Güneş ışınlarının etkisiyle deride %90-95 oranında sentezlenen steroid bir vitamin olan D vitamini eksikliğine bağlı olarak ortaya çıkan semptomlardan insanların genel sağlık durumu ve yaşam kalitesi olumsuz etkilenmektedir. Bu çalışmanın amacı, 2017-2021 yılları arasında Kütahya Sağlık Bilimleri Üniversitesi Evliya Çelebi Eğitim ve Araştırma Hastanesi’ne ayakta tedavi edilen hastaların D vitamini durumlarının yaş, cinsiyet ve mevsime göre değerlendirilmesidir.
Gereç ve Yöntemler: 25-Hidroksi Vitamin D (25-OH VitD) düzeyi çalışılan hastalar, hastane veri tabanından retrospektif olarak incelendi. 121727 hasta çalışmaya dahil edildi. D vitamini eksikliğini etkileyen faktörler lojistik regresyon yöntemi ile belirlendi ve kategoriler arasında risk değerlendirmeleri yapıldı.
Bulgular: 25-OH VitD düzeylerinin ortalama ve standart sapma değerleri 16.73±11.11 ng/ml idi. Eşik değer olarak 20 ng/ml alındığında; hastaların %71.5’inde D vitamini eksikliği vardı. D vitamini düzeyleri özellikle kış mevsiminde, kadınlarda ve yaş ilerledikçe daha düşük bulundu.
Sonuç: Kütahya’da hastaneye başvuran hastalarda D vitamini eksikliğinin yaygın olduğu görülüyor. İlkbahar ve yaz aylarında güneş ışığından daha fazla yararlanmanın, beslenme ve yaşam tarzı değişikliklerinin D vitamini düzeyini olumlu yönde etkileyeceğini düşünüyoruz.

Keywords

Yaş, Cinsiyet, Mevsim, D Vitamini

Evaluation of Vitamin D Levels in Kütahya Province: A Hospital-Based Retrospective Study

Abstract

Objective: The general health status and quality of life of individuals are negatively impacted by symptoms arising from vitamin D deficiency. Vitamin D, a steroid vitamin, is primarily synthesized in the skin (90-95%) under the influence of sunlight. This study aimed to determine the vitamin D status of outpatients admitted to Kütahya Health Sciences University Evliya Çelebi Training and Research (KHSU-ECTR) Hospital between 2017 and 2021, considering age, gender, and season.
Material and Methods: Retrospective analysis was conducted on patients whose 25-Hydroxy Vitamin D (25-OH VitD) levels were studied, using data from the hospital database. The study included a total of 121,727 patients. Logistic regression was utilized to determine factors influencing vitamin D deficiency, and risk assessments were conducted across different categories.
Results: The mean and standard deviation values of 25-OH VitD levels were 16.73±11.11 ng/ml. Using a cut-off value of 20 ng/ml, it was found that 71.5% of the patients exhibited vitamin D deficiency. Notably, vitamin D levels were particularly low among women and the elderly, especially during the winter season.
Conclusion: Vitamin D deficiency is prevalent among patients admitted to the hospital in Kütahya. We think that increasing sun exposure during the spring and summer seasons, as well as implementing dietary and lifestyle changes, will have a positive impact on vitamin D levels.

Keywords

Age, Gender, Season, Vitamin D

References

• Göktaş O, Ersoy C, Ercan I, Can FE. Vitamin D status in the adult population of Bursa-Turkey. Eur J Gen Pract. 2020; 26(1):156-162. DOI: 10.1080/13814788.2020.1846712i
• McKenna MJ, Murray B, Crowley RK, Twomey PJ, Kilbane MT. Laboratory trend in vitamin D status in Ireland: Dual concerns about low and high 25OHD. J Steroid Biochem Mol Biol. 2019; 186:105-109. DOI: 10.1016/j.jsbmb.2018.10.001.
• Mutlu GY, Aksu ED, Bereket A, Hatun Ş. Vitamin D Status Across Age Groups in Turkey: Results of 108,742 Samples from a Single Laboratory. J Clin Res Pediatr Endocrinol. 2020;12(3):248-255. DOI: 10.4274/jcrpe.galenos.2019.2019.0097.
• Vogeser M. Quantification of circulating 25-hydroxyvita¬min D by liquid chromatography-tandem mass spectrom-etry. J Steroid Biochem Mol Biol. 2010; 121(3-5):565-573. DOI: 10.1016/j.jsbmb.2010.02.025.
• Moy FM, Bulgiba A. High prevalence of vitamin D insuf¬ficiency and its association with obesity and metabolic syndrome among Malay adults in Kuala Lumpur, Malaysia. BMC Public Health. 2011; 11(1): 735. DOI:10.1186/1471-2458-11-735.
• Meer IM, Middelkoop BJC, Boeke AJP, Lips P. Prevalence of vitamin D deficiency among Turkish, Moroccan, Indian and sub-Sahara African populations in Europe and their countries of origin: an overview. Osteoporosis International 2011;22:1009-1021. DOI: 10.1007/s00198-010-1279-1
• Shea MK, Houston DK, Tooze JA, Davis CC, Johnson MA, Hausman DB, et al. Correlates and prevalence of insufficient 25-hydroxyvitamin D status in black and white older adults: The health, aging and body composition study. J Am Geriatr Soc. 2011; 59(7): 1165–1174. DOI: 10.1111/j.1532-5415.2011.03476.x.
• Uçar F, Taşlıpınar MY, Soydaş AÖ, Özcan N. Ankara Etlik İhtisas Eğitim ve Araştırma Hastanesine Başvuran Hastalarda 25-OH Vitamin D Düzeyleri. Eur J Basic Med Sci. 2012;2(1):12-15.
• Mallah EM, Hamad MF, Elmanaseer MA, Qinna NA, Idkaidek NM, Arafat TA, et al . Plasma concentrations of 25-hydroxyvitamin D among Jordanians: Effect of biological and habitual factors on vitamin D status. BMC Clin Pathol. 2011;11:8. DOI: 10.1186/1472-6890-11-8.
• Vu LH, Whiteman DC, Pols JC, Kimlin MG, Neale RE. Serum vitamin D levels in office workers in a subtropi¬cal climate. Photochem Photobiol. 2011;87(3):714-720. DOI: 10.1111/j.1751-1097.2011.00899.
• Nanri A, Foo LH, Nakamura K, Hori A, Poudel-Tandukar K, Matsushita Y, et al. Serum 25-hydroxyvi¬tamin D concentrations and season-specific correlates in Japanese adults. Journal of Epidemiology 2011; 21(5): 346-353. DOI: 10.2188/jea.JE20100161
• Holick MF. Vitamin D deficiency. N Engl J Med. 2007; 357(3):266-281. DOI: 10.1056/NEJMra070553.
• Börekçi NÖ. D Vitamini eksikliği ile ilgili güncel bilgiler. The Journal of Turkish Family Physician. 2019; 10 (1): 35-42. DOI: 10.15511/jtfp.19.00135.
• Hossein-nezhad A, Holick MF. Vitamin D for health: A Global perspective. Mayo Clinic Proceedings 2013;88(7):720-755. DOI: 10.1016/j.mayocp.2013.05.011.
• Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr. 2004 Dec; 80(6):1678-1688. DOI: 10.1093/ajcn/80.6.1678S.
• Türkiye Endokrinoloji ve Metabolizma Derneği. Osteoporoz ve Metabolik Kemik Hastalıkları Tanı ve Tedavi Kılavuzu. 2018: 119-127.
• UpToDate. Dawson-Hughes B. Vitamin D deficiency in adults: definition, clinical manifestations, and treatment. (Online). https://www.uptodate.com/contents/vitamin-d-deficiency-in-adults-definition-clinical-manifestations-and-treatment (Accessed:02.06.2022).
• Forrest KY, Stuhldreher WL. Prevalence and correlates of vitamin D deficiency in US adults. Nutr Res. 2011;31(1):48-54. DOI: 10.1016/j.nutres.2010.12.001.
• Lips P. Vitamin D status and nutrition in Europe and Asia. J Steroid Biochem Mol Biol. 2007;103(3-5):620-625. DOI: 10.1016/j.jsbmb.2006.12.076.
• Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, et al. Global vitamin D status and determinants of hypovitaminosis D. Osteoporosis International 2009;20:1807. DOI: 10.1007/s00198-009-0954-6.
• Alagöl F, Shihadeh Y, Boztepe H, Tanakol R, Yarman S, Azizlerli H, et al. Sunlight exposure and vitamin D deficiency in Turkish women. J Endocrinol Invest. 2000; 23(3):173-177.DOI: 10.1007/BF03343702.
• Hekimsoy Z, Dinç G, Kafesçiler S, Onur E, Güvenç Y, Pala T, et al. Vitamin D status among adults in the Aegean region of Turkey. BMC Public Health. 2010;10:782.DOI: 10.1186/1471-2458-10-782.
• Ciğerli O, Parildar H, Unal AD, Tarçın Ö, Erdal R, Demirağ NG. Vitamin D deficiency is a problem for adult out-patients? A university hospital sample in Istanbul, Turkey. Public Health Nutrition 2013;16(7):1306-1313. DOI: 10.1017/S1368980012003588
• Atli T, Gullu S, Uysal AR, Erdoğan G. The prevalence of Vitamin D deficiency and effects of ultraviolet light on vitamin D levels in elderly Turkish population. Archives of Gerontology and Geriatrics 2005; 40:53-60. DOI: 10.1016/j.archger.2004.05.006
• Schoor MN, Lips P. Worldwide vitamin D status. Best Pract Res Clin Endocrinol Metab. 2011; 25(4):671-680. DOI: 10.1016/j.beem.2011.06.007.
• Niculescu DA, Capatina CAM, Dusceac R, Caragheorgheopol A, Ghemigian A, Poiana C. Seasonal variation of serum vitamin D levels in Romania. Arch Osteoporos. 2017;12(1):113. DOI:10.1007/s11657-017-0407-3.
• Gezi Rehberim. Kütahya’nın Coğrafi Yapısı.[Online].https://www.rehberim.gen.tr/turkiye-rehberi/Kütahya/cografya [Accessed:18.05.2022].
• TÜİK. Adrese Dayalı Nüfus Kayıt Sistemi Sonuçları, 2021. [Online]. https://data.tuik.gov.tr/Bulten/Index?p=Adrese-Dayali-Nufus-Kayit-Sistemi-Sonuclari-2021-45500 [Accessed:03.06.2022].
• T.C. Çevre, Şehircilik ve İklim Değişikliği Bakanlığı, Meteoroloji Genel Müdürlüğü. [Online].https://www.mgm.gov.tr/veridegerlendirme/il-ve-ilceler-istatistik.aspx?m=KÜTAHYA [Accessed:03.06.2022].
• Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911-1930. DOI:10.1210/jc.2011-0385.
• Lips P, Cashman KD, Lamberg-Allardt C, Bischoff-Ferrari HA, Obermayer-Pietsch B, Bianchi ML, et al. Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcified Tissue Society. Eur J Endocrinol. 2019;180(4):23-54. DOI: 10.1530/EJE-18-0736
• Balcı C, Toktaş N. D Vitamini Sentezi, Metabolizması ve Sağlık Üzerine Etkileri. Gazi Sağlık Bilimleri Dergisi. 2021;6(1):33-47.
• Mansoor S, Habib A, Ghani F, Fatmi Z, Bedrettin S, Mansur S, et al. Prevalence and sig¬nificance of vitamin D deficiency and insufficiency among apparently healthy adults. Clinical Biochemistry 2010; 43: 1431-1435. DOI: 10.1016/j.clinbiochem.2010.09.022
• Akman AO, Tumer L, Hasanoğlu A, İlhan M, Çaycı B. Frequency of vitamin D insufficiency in healthy children between 1 and 16 years of age in Turkey. Pediatrics International 2011; 53: 968-973. DOI: 10.1111/j.1442-200X.2011.03486.x.
• Özdin M, Mundan D. Çocuklarda D Vitamini Düzeylerinin Bazı Faktörler Açısından İncelenmesi. Aksaray Üniversitesi Tıp Bilimleri Dergisi. 2022; 3(2): 13-17.
• Çınar N, Harmancı A, Yıldız BO, Bayraktar M. Vitamin D status and seasonal changes in plasma concentrations of 25-hydroxyvitamin D in office workers in Ankara, Turkey. European Journal of Internal Medicine. 2014; 25(2): 197–201.DOI:http://dx.doi.org/10.1016/j.ejim.2013.11.004
• Cashman KD. Vitamin D Deficiency: Defining, Prevalence, Causes, and Strategies of Addressing. Calcified Tissue International. 2020;106(1):14-29. DOI: 10.1007/s00223-019-00559-4
• Meletli Ö, Yılmaz M, Çalan M, Demir T. Serum D Vitamini Düzeyi ile Lipidlerin İlişkisi. Medical Journal of İzmir Hospital. 2021; 25(3): 245-250.
• Aydın FY, Yerlikaya ŞB. D Vitamini Düzeyi ile Kan Eozinofil Sayısı Arasındaki İlişki. Sürekli Tıp Eğitimi Dergisi. 2022; 31(1):43-49. DOI: https://doi.org/10.17942/sted.1066260.
• Sirajudeen S, Shah I, Al Menhali A. A Narrative Role of Vitamin D and Its Receptor: With Current Evidence on the Gastric Tissues. Int J Mol Sci. 2019;20(15):3832. DOI: 10.3390/ijms20153832.