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A systematic review of vitamin D status in populations worldwide

  • Jennifer Hilger (a1), Angelika Friedel (a2), Raphael Herr (a1), Tamara Rausch (a1), Franz Roos (a2), Denys A. Wahl (a3), Dominique D. Pierroz (a3), Peter Weber (a2) and Kristina Hoffmann (a1)
  • DOI: http://dx.doi.org/10.1017/S0007114513001840
  • Published online: 09 August 2013
Abstract

Vitamin D deficiency is associated with osteoporosis and is thought to increase the risk of cancer and CVD. Despite these numerous potential health effects, data on vitamin D status at the population level and within key subgroups are limited. The aims of the present study were to examine patterns of 25-hydroxyvitamin D (25(OH)D) levels worldwide and to assess differences by age, sex and region. In a systematic literature review using the Medline and EMBASE databases, we identified 195 studies conducted in forty-four countries involving more than 168 000 participants. Mean population-level 25(OH)D values varied considerably across the studies (range 4·9–136·2 nmol/l), with 37·3 % of the studies reporting mean values below 50 nmol/l. The highest 25(OH)D values were observed in North America. Although age-related differences were observed in the Asia/Pacific and Middle East/Africa regions, they were not observed elsewhere and sex-related differences were not observed in any region. Substantial heterogeneity between the studies precluded drawing conclusions on overall vitamin D status at the population level. Exploratory analyses, however, suggested that newborns and institutionalised elderly from several regions worldwide appeared to be at a generally higher risk of exhibiting lower 25(OH)D values. Substantial details on worldwide patterns of vitamin D status at the population level and within key subgroups are needed to inform public health policy development to reduce risk for potential health consequences of an inadequate vitamin D status.

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*Corresponding author: Dr K. Hoffmann, fax +49 621 383 9920, email kristina.hoffmann@medma.uni-heidelberg.de
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