title: Influence of external, intrinsic and individual behaviour variables on serum 25(OH)D in a German survey.
abstract: The objective of the present study was to identify external, intrinsic or behavioural factors that significantly influenced serum 25-hydroxyvitamin D (25(OH)D) concentrations in a German survey. Data from 3061 participants in the Cooperative Health Research in the Region of Augsburg, Germany (KORA) F4 survey were used to relate potential determinants to measured mean serum 25(OH)D concentrations using multivariable regression models. The factors significantly associated with hypovitaminosis D (defined as 25(OH)D<25 nmolL(-1)) were season (winter, spring and autumn), urban environment and high body mass index. In contrast, times spent in sunny regions, hours per day spent outdoors in the summer as well as additional oral intake were associated with higher 25(OH)D concentrations. These results suggest that mainly ambient UV exposure but also individual behaviour are the most important determinants for personal 25(OH)D concentrations. The analyses further showed that in winter 43% of subjects were vitamin D deficient and 42% insufficient. Even in summer over half the population has insufficient vitamin D status with 8% deficient and 47% insufficient. Therefore measures to mitigate widespread vitamin D insufficiency such as regular short-term sun exposure and/or improved dietary intake/supplementation recommendations by public health bodies need to be considered.
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany. Electronic address: katja.richter@helmholtz-muenchen.de.
authors.forename: Katja
authors.initials: K
authors.lastname: Richter
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Breitner
authors.affiliation: School of Earth Atmospheric and Environmental Sciences, University of Manchester, Manchester, UK.
authors.forename: Ann R
authors.initials: AR
authors.lastname: Webb
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Huth
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Thorand
authors.affiliation: School of Earth Atmospheric and Environmental Sciences, University of Manchester, Manchester, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Kift
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.
authors.forename: Jakob
authors.initials: J
authors.lastname: Linseisen
authors.affiliation: Public Health and Health Services Research, Ludwig-Maximilians-Universität München, Germany.
authors.forename: Angela
authors.initials: A
authors.lastname: Schuh
authors.affiliation: Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Leipzig, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Kratzsch
authors.affiliation: Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Neuherberg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Mielck
authors.affiliation: Department of Dermatology, Allergology, and Venereology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Weidinger
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Peters
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Schneider
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001519:Behavior; D015992:Body Mass Index; D003625:Data Collection; D019587:Dietary Supplements; D005260:Female; D005858:Germany; D006304:Health Status; D006801:Humans; D008027:Light; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012621:Seasons; D012737:Sex Factors; D012923:Social Class; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000453:epidemiology; D044465:White People / Q000523:psychology*
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: 25(OH)D; KORA F4; UV exposure; Vitamin D