title: Effect of adiposity, season, diet and calcium or vitamin D supplementation on the vitamin D status of healthy urban African and Asian-Indian adults.
abstract: Vitamin D deficiency has been implicated in the aetiology of infectious diseases and metabolic syndrome. These diseases are prevalent in the African and Asian-Indian populations of South Africa; however, there is limited data on 25-hydroxyvitamin D (25(OH)D) concentrations in these populations. The aim of the present study was to assess the vitamin D status and its predictors in healthy adults in Johannesburg. We assessed the vitamin D status of 730 adult African and Asian-Indian subjects residing in Johannesburg. The contributions of sun exposure, season, dietary intake of Ca and vitamin D, total body fat and body fat distribution to 25(OH)D concentrations were assessed. The concentrations of 25(OH)D were measured by HPLC. The contribution of 25(OH)D₃ to total 25(OH)D concentrations was assessed. The mean age of the subjects was 42·6 (SD 13·1) years (range: 18-65). Concentrations of 25(OH)D < 30 nmol/l were found in 28·6 % of the Asian-Indian subjects in comparison with 5·1 % of the African subjects (P< 0·0001). Parathyroid hormone (PTH) concentrations were negatively associated with 25(OH)D concentrations, while season and sun exposure were positive predictors explaining 16 % of the variance in 25(OH)D concentrations (P< 0·0001) in the African subjects. In the Asian-Indian subjects, PTH concentrations were negatively associated with 25(OH)D concentrations, while male sex, season and Ca supplementation were positive predictors and explained 17 % of the variance in 25(OH)D concentrations (P< 0·0001). In the multivariate regression analysis, neither total body fat nor body fat distribution was predictive of 25(OH)D concentrations in either group. In conclusion, factors such as sun exposure, dietary supplement use and ethnicity are important determinants of plasma 25(OH)D concentrations.
authors.affiliation: National Health Laboratory Service, Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand,7 York Road, Parktown,Johannesburg2193,South Africa.
authors.forename: Jaya A
authors.initials: JA
authors.lastname: George
authors.affiliation: MRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand,Johannesburg,South Africa.
authors.forename: Shane A
authors.initials: SA
authors.lastname: Norris
authors.affiliation: Lancet Laboratories,Auckland Park,Johannesburg,South Africa.
authors.forename: Hendrick E
authors.initials: HE
authors.lastname: van Deventer
authors.affiliation: MRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand,Johannesburg,South Africa.
authors.forename: John M
authors.initials: JM
authors.lastname: Pettifor
authors.affiliation: National Health Laboratory Service, Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand,7 York Road, Parktown,Johannesburg2193,South Africa.
authors.forename: Nigel J
authors.initials: NJ
authors.lastname: Crowther
mesh_terms: D015652:25-Hydroxyvitamin D 2 / Q000097:blood; D050154:Adiposity; D000328:Adult; D002112:Calcifediol / Q000097:blood; D002136:Calcium, Dietary / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects / Q000208:ethnology; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007194:India / Q000208:ethnology; D008297:Male; D015995:Prevalence; D012621:Seasons; D012727:Sex Characteristics; D012867:Skin / Q000528:radiation effects*; D013019:South Africa / Q000453:epidemiology; D013472:Sunlight; D014504:Urban Health / Q000208:ethnology; D014807:Vitamin D / Q000008:administration & dosage / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control*
chemical_list: D002136:Calcium, Dietary; D014807:Vitamin D; D015652:25-Hydroxyvitamin D 2; D002112:Calcifediol