Vitamin D Deficiency and Its Predictors in a Country with Thirteen Months of Sunshine: The Case of School Children in Central Ethiopia
Vitamin D Deficiency and Its Predictors in a Country with Thirteen Months of Sunshine: The Case of School Children in Central Ethiopia
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DOI：
10.1371/journal.pone.0120963
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发表时间：
2015-03-30
期刊：
影响因子：
3.7
通讯作者：
Whiting, Susan J.
中科院分区：
文献类型：
--
作者：
Wakayo, Tolassa;Belachew, Tefera;Whiting, Susan J.
对生活在阳光明媚的气候中的儿童的维生素D状况进行的研究表明，儿童没有获得足够的维生素D，然而，在埃塞俄比亚的儿童中并没有考虑到这一点。在这项研究中，我们通过检测循环中的25-羟基维生素D[25(OH)D]来确定11-18岁学龄儿童的维生素D缺乏症及其预测因素。这项以学校为基础的横断面研究是在阿达马镇(n=89)和农村(n=85)的学校进行的，样本总数为174人。采用多阶段分层抽样的方法从两个环境中随机抽取学生。获得了父母的社会经济状况以及人口统计学、人体测量学、太阳暴晒状况和血25(OH)D水平。维生素D缺乏，定义为循环中25(OH)D<；50nmol/L的水平，在整个研究参与者中发现了42%。城市学生的缺乏症患病率明显高于农村学生(分别为61.8%和21.2%，p<；0.001)。用多因素Logistic回归模型控制可能的混杂因素后，日照时间、身体部位日光暴露量、居住地、母亲文化程度、肥胖、家里有电视/电脑、社会经济状况是维生素D缺乏的显著预测因素。结果表明，维生素D缺乏症在常年有充足阳光提供UVB的城市和农村地区的健康学龄儿童中普遍存在，在阳光照射较少的城市学龄儿童中维生素D缺乏症的患病率显著高于城市学龄儿童。在埃塞俄比亚这样的热带国家，改变行为沟通以增加紫外线暴露对于预防维生素D缺乏症至关重要。还需要进一步的研究来评估其缺乏对埃塞俄比亚生长中的儿童在骨骼发育的最关键时期的骨矿平衡的有害影响。
Studies examining vitamin D status among children living in sunny climates indicated that children did not receive adequate vitamin D, however, this has not been looked at among children living in Ethiopia. In this study, we determined vitamin D deficiency and its predictors among school children aged 11-18 years, examining circulating 25-hydroxy vitamin D [25(OH)D]. The school-based cross-sectional study was conducted in schools in Adama Town (n = 89) and in rural Adama (n = 85) for a total sample of 174. Students were randomly selected using multi-stage stratified sampling method from both settings. Socioeconomic status of parents and demographic, anthropometric, sun exposure status and blood 25(OH)D levels were obtained. Vitamin D deficiency, defined as circulating levels of 25(OH)D < 50 nmol/L, was found in 42% of the entire study participants. Prevalence of deficiency was significantly higher among students in urban setting compared to rural (61.8% vs 21.2%, respectively, p< 0.001). After controlling for potential confounders using multivariable logistic regression model, duration of exposure to sunlight, amount of body part exposed to sunlight, place of residence, maternal education, body fatness, having TV/computer at home and socioeconomic status were significant predictors of vitamin D deficiency. The findings suggest that Vitamin D deficiency was prevalent in healthy school children living both in urban and rural areas of a country with abundant year round sunshine providing UVB, with the prevalence of deficiency being significantly higher among urban school children who were less exposed to sunlight. Behaviour change communication to enhance exposure to ultraviolet light is critical to prevent vitamin D deficiency in tropical country like Ethiopia. Further study is required to assess the deleterious effect of its deficiency on bone mineral homeostasis of growing children in Ethiopia during their most critical period of bone development.