[Hypovitaminosis D among 18-to-49-years-old women wearing concealing clothes, an ignored reality in general practice].
BACKGROUND
Although the morbidity and mortality of vitamin D deficiency are well known in the elderly and among children, doctors are unlikely to consider it as a diagnosis in young adults, even when it is symptomatic. Numerous additional examinations are thus unnecessarily prescribed, while diagnosis is delayed. After observing several cases of severe vitamin D deficiency among women aged 18 to 49 years who wore concealing clothing, we conducted an investigation of the prevalence of this vitamin deficiency in this community. We asked ourselves 2 questions: What proportion of women in this population has a vitamin D deficiency and how severe is it? Are general practitioners (GPs) aware of this problem?


METHODS
A cross-sectional study was conducted in Lyon, located at a latitude 45 N. We included women aged 18 to 49 years, who wore concealing clothes, and consulted their GP from November 2005 through March 2006 and had no disease likely to cause hypovitaminosis D. Physicians completed a questionnaire and collected serum for a vitamin 25 (OH)D assay. We looked for correlations between vitamin D deficiency and several factor: ages, parity, associated diseases, and clinical signs.


RESULTS
The study included 96 women. Defining hypovitaminosis D at a threshold of 53 nmol/L or 75 nmol/L, we found a prevalence of 99%, and 72.6% of the women had symptoms. Using a stricter threshold of 30 nmol/L, below which secondary hyperparathyroidism can appear and reduce bone mass, we found a prevalence of 82.5%, 71% of whom were symptomatic. The failure to prescribe vitamin D supplementation during the previous 3 months for 99% of these women indicates that GPs are not aware of this issue.


CONCLUSIONS
These results highlight the endemic character of vitamin D deficiency in a population of young women of childbearing age, usually in good health. GPs must be involved in targeted activities to screen for and prevent vitamin D deficiency among this population, because food sources provide minimal quantities of vitamin D.
Université Claude Bernard, F-69008 Lyon, France. belsony@yahoo.fr
Sonja
S
Belaid
Ambroise
A
Martin
Anne-Marie
AM
Schott
Martine
M
Laville
Marie-France
MF
Le Goaziou
D000293:Adolescent; D000328:Adult; D003020:Clothing; D005194:Family Practice; D005260:Female; D006801:Humans; D008875:Middle Aged; D014808:Vitamin D Deficiency / Q000175:diagnosis / Q000453:epidemiology