Hypovitaminosis D in adolescent females – an analytical cohort study in the United Arab Emirates

Abstract

Background:

Despite living in a sunny country, hypovitaminosis D is common in women of reproductive age in Al Ain, United Arab Emirates (UAE).

Aims and objectives:

To establish the prevalence of hypovitaminosis D in adolescent female Emirati nationals and its risk factors.

Methods:

This was an analytical prospective cohort study of 350 female Emirati nationals aged 11–18 years attending public schools in Al Ain. Socio-economic status, diet and amount of sun exposure were evaluated by face-to-face interviews. Serum total 25 (OH) vitamin D (D₂ + D₃) levels were measured by electrochemiluminescence assay. The prevalence of hypovitaminosis D was calculated and the association with risk factors analysed.

Results:

Data were complete for 293 girls. Only one girl [prevalence 0·3%, 95% confidence interval (CI) 0·01–1·9] had vitamin D sufficiency (serum vitamin D levels >75 nmol/L). Three girls (1·0%, 95% CI 0·2–2·9) had vitamin D insufficiency (50–75 nmol/L), 58 (19·8%, 95% CI 15·0–25·5) were deficient (27·5–50 nmol/L) and 231 (78·8%, 95% CI 68·9–89·6) had severe deficiency (<27·5 nmol/L). Serum vitamin D levels declined between the ages of 11 and 13 years before progressively rising until the age of 18 years but without regaining the levels they were at the age of 11. There was no statistically significant difference between the vitamin D status groups in age, body mass index, accommodation type, family income, percentage of surface area unexposed to the sun when outdoors, consumption of oily fish or total vitamin D intake.

Conclusion:

The finding of a high prevalence of hypovitaminosis D in adolescent females in UAE is of serious concern for their health and that of their infants during their reproductive lives. Adolescent girls with a similar social and cultural background currently living in less sunny, industrialised countries might also be at risk.

Keywords:

• Vitamin D
• Diet
• Sunlight
• Middle East
• Epidemiology

Acknowledgments

We thank the staff of the participating schools, the Department of Al Ain Educational Zone, Abu Dhabi Education Council and all the girls who participated and their families. The study was funded exclusively by a research grant from the College of Medicine and Health Sciences, United Arab Emirates University (NP-10-11/104), but they had no role in the study design, collection, analysis and interpretation of data, writing of the manuscript or in the decision to submit the manuscript for publication. There was no external funding.