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Zurita-Salinas C, Tello B, Dueñas-Espín I, Zurita J, Acosta W, León CA, Andrade-Muñoz A, Pareja-Maldonado J. Evaluating low and high vitamin D levels in Ecuadorian cities from 2018 to 2022: interrupted time series and a cross-sectional study. BMJ Open 2024; 14:e079960. [PMID: 38670624 PMCID: PMC11057257 DOI: 10.1136/bmjopen-2023-079960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 03/14/2024] [Indexed: 04/28/2024] Open
Abstract
OBJECTIVES To identify differences in the mean vitamin D concentrations in samples obtained from a private laboratory in Quito and to explore their relationship with the pre-pandemic and pandemic periods spanning from 2018 to 2022. DESIGN A combination of an interrupted time series design and a retrospective cross-sectional approach. SETTING AND PARTICIPANTS The study involved 9285 participants who had their 25-hydroxyvitamin D (25(OH)D) levels tested at a well-known private laboratory in Quito, Ecuador, from 2018 to 2022. PRIMARY AND SECONDARY OUTCOME MEASURES The 25(OH)D levels were analysed and assessed for correlations with age, and the year the measurements were taken. RESULTS The mean 25(OH)D level was 27.53 ng/mL (± 14.11). Approximately 68.8% of participants had serum 25(OH)D levels of less than 30 ng/mL, and 0.6% showed potential harm from excess 25(OH)D, with levels over 100 ng/mL. The analysis indicated a significant monthly increase of 0.133 units in 25(OH)D levels (p=0.006). However, the period after March 2020, compared with before, saw a non-significant decrease of 1.605 units in mean 25(OH)D levels (p=0.477). CONCLUSIONS The study's findings indicate a significant prevalence of 25(OH)D deficiency, underscoring the necessity for preventative measures. However, the increasing trend in high 25(OH)D levels is concerning, emphasising the importance of prudent vitamin D supplement prescriptions and public education against self-medication. For efficient resource allocation and targeting of those with higher risks, it may be advantageous to concentrate vitamin D testing on specific population groups.
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Affiliation(s)
- Camilo Zurita-Salinas
- Biomedical Research Unit, Zurita & Zurita Laboratories, Quito, Ecuador
- Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
| | - Betzabé Tello
- Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
- Centro de Investigación para la Salud en América Latina (CISeAL), Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Iván Dueñas-Espín
- Instituto de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Jeannete Zurita
- Biomedical Research Unit, Zurita & Zurita Laboratories, Quito, Ecuador
- Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - William Acosta
- Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | | | - Andrés Andrade-Muñoz
- Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
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Paparodis RD, Bantouna D, Karvounis E, Zoupas I, Livadas S, Angelopoulos N, Imam S, Papadimitriou DT, Jaume JC. Intense Testing and Use of Vitamin D Supplements Leads to Slow Improvement in Vitamin D Adequacy Rates: A Cross-Sectional Analysis of Real-World Data. Nutrients 2023; 16:111. [PMID: 38201941 PMCID: PMC10780961 DOI: 10.3390/nu16010111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/11/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Vitamin D testing (VDT) and supplement use (VDS) are on the rise, but most patients remain deficient (<30 ng/mL-VDD). We designed the present real-world study to assess this paradox. METHODS We reviewed data from all patients visiting our clinics between 2014 and 2022. We estimated the rate of patients with vitamin D adequacy (≥30 ng/mL) (VDA) by year and month of testing, the dose of VDS (low (≤1200 IU/day), medium (1201-3000 I/day) and high dose (>3000 IU/day)), intake duration (short-term (<12 months) and long-term use (≥12 months)), and timing of use (current use, former use, no use). RESULTS We enrolled n = 6912 subjects with vitamin D measurements: n = 5195 females (75.2%), age 44.0 ± 16.8 years, BMI 27.9 ± 6.5 kg/m2; never users: n = 5553 (80.3%), former users: n = 533 (7.7%), current users: n = 826 (12.0%). Current use of VDS was higher in females. VDT rose from 42.1% in 2014 to 92.7% in 2022, and VDA rose from 14.8% to 25.5% for the same time. VDA was found overall in n = 1511 (21.9%); Never users: n = 864 (15.6%), Former users: n = 123 (23.2%); and Current users: n = 370 (44.8%). The maximal VDA (67.9%) was found in subjects using high-dose VDS in the long term. CONCLUSIONS Despite the significant rise in VDT and VDS use, VDA was found in a minority of patients. Prolonged use of high-dose supplements produces modest improvements in VDA.
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Affiliation(s)
- Rodis D. Paparodis
- Endocrinology, Diabetes and Metabolism Clinics, Private Practice, 26221 Patras, Greece
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, University of Toledo, Toledo, OH 43614, USA;
- Hellenic Endocrine Network, 10682 Athens, Greece; (D.B.); (S.L.); (N.A.); (D.T.P.)
- Department of Medicine, Edward Hines, Jr. VA Hospital, Loyola University Chicago, Hines, IL 60141, USA;
| | - Dimitra Bantouna
- Hellenic Endocrine Network, 10682 Athens, Greece; (D.B.); (S.L.); (N.A.); (D.T.P.)
| | - Evangelos Karvounis
- Endocrine Surgery Center of Excellence, Euroclinic Hospital, 11528 Athens, Greece;
| | - Ioannis Zoupas
- School of Medicine, University of Athens, 11527 Athens, Greece;
| | - Sarantis Livadas
- Hellenic Endocrine Network, 10682 Athens, Greece; (D.B.); (S.L.); (N.A.); (D.T.P.)
- Division of Endocrinology, Diabetes and Metabolism, Athens Medical Center, 11528 Athens, Greece
- Endocrinology, Diabetes and Metabolism Clinics, Private Practice, 11528 Athens, Greece
| | - Nicholas Angelopoulos
- Hellenic Endocrine Network, 10682 Athens, Greece; (D.B.); (S.L.); (N.A.); (D.T.P.)
- Endocrinology, Diabetes and Metabolism Clinics, Private Practice, 65302 Kavala, Greece
| | - Shahnawaz Imam
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, University of Toledo, Toledo, OH 43614, USA;
| | - Dimitrios T. Papadimitriou
- Hellenic Endocrine Network, 10682 Athens, Greece; (D.B.); (S.L.); (N.A.); (D.T.P.)
- Medical School, University of Thessaly, 41223 Larisa, Greece
| | - Juan C. Jaume
- Department of Medicine, Edward Hines, Jr. VA Hospital, Loyola University Chicago, Hines, IL 60141, USA;
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