Comorbidity and health-related quality of life in Somali women living in Sweden

Abstract

Objective: To explore the relationship between low serum vitamin D levels and comorbidity in Somali women, immigrants to Sweden.

Design and setting: Cohort study in a Primary Health Care Center and a University Hospital.

Subjects: Somali women skin type V, n = 114, aged 18–56 years, from latitude 0–10^○ N, living in Sweden, latitude 57^○ N > 2 years were compared with women from a population sample, skin type II-III, n = 69, aged 38–56 years, the WHO MONICA study, Gothenburg, Sweden.

Main outcome measures: Serum (S)-25(OH)D, S-parathyroid hormone (PTH), comorbidity and Health-Related Quality of Life (HRQoL) using the Short Form-36 (SF-36) and part of the EQ-5D questionnaires. All calculations were corrected for age.

Results: Vitamin D deficiency (S-25(OH)D < 25 nmol/l) was found in 73% of the Somali women and in 1% of the controls (p < .0001). S-PTH was elevated (>6.9 pmol/l) in 26% and 9%, respectively (p < .004). Somali women used less medication, 16% vs. 55%, p < .0001) but more allergy medication, 11% vs. 7% (p = .006), had fewer fractures, 2% vs. 28% (p < .0001) and lower HRQoL in 7 out of 9 scales (p < .05–.001), than native controls. There were no differences in the prevalence of diabetes mellitus, hypothyroidism, positive thyroid peroxidase antibodies, vitamin B12 deficiency, celiac disease or hypertension.

Conclusions: Vitamin D deficiency was common in Somali women living in Sweden, 73%, but comorbidity was low. Both mental, and especially physical HRQoL scores were lower in the Somali women. The effects of long-lasting deficiency are unknown.

Key points

• The aim was to explore the relationship between vitamin D deficiency (S-25(OH)D < 25 nmol/l) and comorbidity in immigrants.

• Vitamin D deficiency was common in Somali women living in Sweden, 73%, but comorbidity of hypothyroidism, diabetes mellitus, hypertension, fractures and use of medications was low.

• Both mental, and especially physical, Health-Related Quality of Life were lower in the Somali women than in native Swedish women.

• The effects of long-lasting deficiency are unknown.

Keyword:

• Immigrants
• women
• vitamin D deficiency
• comorbidity
• Health-Related Quality of Life

Acknowledgements

We are grateful to Stella Nakate and Tarja Stenius for their invaluable assistance in coordinating the WHO MONICA project and the Somali women during the recruitment and follow-up stages of the study.

Disclosure statement

The authors have no conflicts of interest related to this work.

Ethical approval

The study was approved by the Ethics Committee at the University of Gothenburg, following the Helsinki Declaration, 088/06, T282/11 and 410/08, T063/15 and the National Data Inspection Board, and all participants gave their written informed consent.

Additional information

Funding

The study was financed by grants from the Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement [ALFGBG-718611] and the Gothenburg Medical Association [GLS-170961].