title: The high prevalence of vitamin D inadequacy and dress style of women in the sunny UAE.
abstract: In the UAE, 255 women with different dressing styles (veiled and non-veiled) underwent assay for vitamin D(3). The vitamin level was suboptimal in all groups including those dressed in Western style. The contribution of hypovitaminosis D to osteoporosis was less impressive compared to that of age factor.
  
  
  BACKGROUND
  Vitamin D deficiency is attributed to several causes including clothing styles that hinder exposure to sunlight. This work represents our experience of such issue and its relevance to osteoporosis.
  
  
  METHODS
  Two hundred and fifty-five women either fully covered (96, group G1), covered but face and hands exposed (104, group G2) or dressed in Western style (55, group G3) all underwent immunoassay of 25(OH)D; 78 % of them were Middle Easterners and North Africans. The mean age was 44.8 ± 14.6 years.
  
  
  RESULTS
  In the entire cohort, hypovitaminosis D prevalence was found to be 90.5 % (mean of 25(OH)D, 19.3 ± 9.35 ng/ml). The prevalence was 90.5, 94 and 83 % (all p = not significant (NS)), with a mean value of 17.6 ± 5.45, 16 ± 5.23 and 18.6 ± 6.18 ng/ml in the three groups, respectively. Significant differences in the mean value were observed between G1 vs. G2 (p = 0.04) and G2 vs. G3 (p = 0.01). Fifty-one women in G1 had longer adherence to their dressing habit than 68 in G2, yet the mean level of 25(OH)D was significantly lower in the latter (p = 0.008). Osteoporosis was found in 45/202 (22 %): 24.5, 22.5 and 14.5 % in the three groups, respectively (all p = NS). Patients with osteoporosis were significantly older than others with normal dual X-ray absorptiometry outcome. Values of serum calcium, phosphorus, alkaline phosphatase, mild to moderate secondary hyperparathyroidism and low 25(OH)D were comparable in the two groups.
  
  
  CONCLUSIONS
  The pattern and longevity of dressing style should not be used as pretext for the hypovitaminosis D before other factors are being examined or considered.
authors.affiliation: Department of Internal Medicine and Rheumatology, Al Noor Hospital, Airport Road, PO Box 60420, Abu Dhabi, United Arab Emirates. haideralattia@hotmail.com
authors.forename: Haider M
authors.initials: HM
authors.lastname: Al Attia
authors.forename: Mazin A
authors.initials: MA
authors.lastname: Ibrahim
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003020:Clothing / Q000706:statistics & numerical data*; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000453:epidemiology; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D013472:Sunlight; D014479:United Arab Emirates / Q000453:epidemiology; D014808:Vitamin D Deficiency / Q000453:epidemiology*; D055815:Young Adult