title: Vitamin D deficiency in Tunisia.
abstract: This study seeks to estimate the status of serum 25-hydroxyvitamin D [25(OH)D] in a healthy section of the population in Tunisia and to compare the achieved results with other published data. A transverse descriptive inquiry was carried out between January and March 2002. Three hundred and eighty-nine subjects aged 20-60 years were included in the study. A questionnaire was used to investigate clinical characteristics: sunlight exposure to ultraviolet light and, for women, parity, breast feeding, whether or not they wore the veil, and menopause. A dietary investigation estimated calcium and vitamin D intake. Morning fasting blood was collected from each subject for the measurement of the following parameters: serum calcium, phosphorus, albumin, alkaline phosphatase, 25(OH)D, parathyroid hormone (PTH). Hypovitaminosis D was defined by a cut-off of 37.5 nmol/l. The population studied was largely female, for the greater part housewives. The accumulated prevalence of hypovitaminosis D was 47.6%, increasing with age. Hypovitaminosis is highly prevalent in women (P<0.001). Multiparity, menopause, wearing the veil, and calcium and vitamin D dietary intake are factors associated with hypovitaminosis D (P<0.05). Analysis of logistic regression shows that only multiparity and vitamin D dietary intake are independent predictive factors. The status of serum 25(OH)D in Tunisia resembles that in southern European countries rather than in Middle Eastern countries. Insufficient vitamin D diet intake, higher parity and wearing the veil explain this deficiency in Tunisia. Dietary enrichment or supplementation by vitamin D and a more outdoor lifestyle, especially for older people, should be seriously considered as a way to reduce this deficiency in Tunisia.
authors.affiliation: Department of Rheumatology, Rabta Hospital, 1006, Tunis, Tunisia. nihel.besbes@rns.tn
authors.forename: N
authors.initials: N
authors.lastname: Meddeb
authors.forename: H
authors.initials: H
authors.lastname: Sahli
authors.forename: M
authors.initials: M
authors.lastname: Chahed
authors.forename: J
authors.initials: J
authors.lastname: Abdelmoula
authors.forename: M
authors.initials: M
authors.lastname: Feki
authors.forename: Hadj
authors.initials: H
authors.lastname: Salah
authors.forename: S
authors.initials: S
authors.lastname: Frini
authors.forename: N
authors.initials: N
authors.lastname: Kaabachi
authors.forename: Ch
authors.initials: Ch
authors.lastname: Belkahia
authors.forename: R
authors.initials: R
authors.lastname: Mbazaa
authors.forename: B
authors.initials: B
authors.lastname: Zouari
authors.forename: S
authors.initials: S
authors.lastname: Sellami
mesh_terms: D000328:Adult; D002118:Calcium / Q000097:blood; D002136:Calcium, Dietary / Q000008:administration & dosage; D003020:Clothing; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008593:Menopause / Q000502:physiology; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010298:Parity; D015995:Prevalence; D013472:Sunlight / Q000009:adverse effects; D014416:Tunisia / Q000453:epidemiology; D014807:Vitamin D / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000453:epidemiology* / Q000503:physiopathology
chemical_list: D002136:Calcium, Dietary; D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D002118:Calcium