title: Global vitamin D status and determinants of hypovitaminosis D.
abstract: This review describes the vitamin D status in different regions of the world with the objective of understanding the scope of hypovitaminosis D and the factors related to its prevalence that may contribute to the pathogenesis of osteoporosis and fragility fractures.
  
  
  BACKGROUND
  Vitamin D status has been linked to the pathogenesis of hip fractures as well as other skeletal and non-skeletal disorders. The purpose of this review is to provide a global perspective of vitamin D status across different regions of the world and to identify the common and significant determinants of hypovitaminosis D.
  
  
  METHODS
  Six regions of the world were reviewed-Asia, Europe, Middle East and Africa, Latin America, North America, and Oceania-through a survey of published literature.
  
  
  RESULTS
  The definition of vitamin D insufficiency and deficiency, as well as assay methodology for 25-hydroxyvitamin D or 25(OH)D, vary between studies. However, serum 25(OH)D levels below 75 nmol/L are prevalent in every region studied whilst levels below 25 nmol/L are most common in regions such as South Asia and the Middle East. Older age, female sex, higher latitude, winter season, darker skin pigmentation, less sunlight exposure, dietary habits, and absence of vitamin D fortification are the main factors that are significantly associated with lower 25(OH)D levels.
  
  
  CONCLUSIONS
  Reports from across the world indicate that hypovitaminosis D is widespread and is re-emerging as a major health problem globally.
authors: Indraprastha Apollo Hospitals, Sarita Vihar, Delhi-Mathura Road, 110044 New Delhi, India. ambrish.mithal@rediffmail.com
authors: A
authors: A
authors: Mithal
authors: D A
authors: DA
authors: Wahl
authors: J-P
authors: JP
authors: Bonjour
authors: P
authors: P
authors: Burckhardt
authors: B
authors: B
authors: Dawson-Hughes
authors: J A
authors: JA
authors: Eisman
authors: G
authors: G
authors: El-Hajj Fuleihan
authors: R G
authors: RG
authors: Josse
authors: P
authors: P
authors: Lips
authors: J
authors: J
authors: Morales-Torres
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003431:Cross-Cultural Comparison; D005260:Female; D020022:Genetic Predisposition to Disease; D014943:Global Health; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
chemical_list: D014807:Vitamin D