Estado de la vitamina D en adultos uruguayos aparentemente saludables, en invierno y en Montevideo

Juan C. Bagattini; Enrique Barrios; Raúl Barañano; Gastón Moratorio; José María Montes; Silvana G. Laporte; Rosina Ordoqui; Fiorella L. Cavalleri; Carlos Ortega; Thaïs Forster

Juan C. Bagattini CLAEH. Facultad Medicina. Departamento de Medicina. Director
Enrique Barrios Universidad de la República. Facultad de Medicina. Departamento de Métodos Cuantitativos. Director
Raúl Barañano MEDILAB. MSc-Director
Gastón Moratorio MEDILAB. Director
José María Montes Laboratorio FERTILAB. Director
Silvana G. Laporte Laboratorio FERTILAB
Rosina Ordoqui Laboratorio FERTILAB
Fiorella L. Cavalleri Universidad de la República. Facultad de Medicina. Departamento de Métodos Cuantitativos
Carlos Ortega Universidad de la República. Facultad de Medicina. Departamento de Métodos Cuantitativos
Thaïs Forster Hospital Británico. Centro de Documentación e Información Científica

Keywords: VITAMIN D, ADULTS, WINTER, URBAN POPULATION, VITAMIN D DEFICIENCY, PARATHYROID HORMONE, IONIZED CALCIUM

Abstract

Objective: Determine the prevalence of the “Vitamin D Status” through the serum levels of total 25(OH) Vit D and its relationship with age, sex, ethnicity, BMI, usual sun exposure and parameters of the phosphate-calcium metabolism, in an adult population, of both sexes, asymptomatic and apparently healthy, in winter, in Montevideo (Latitude 34,50° S).
Material and methods: Cross-sectional, descriptive study where 175/331 outpatient subjects (95% ≤ 50), 102 men and 73 women (95% premenopausal), Caucasian (84%), usual sun exposure (43%), BMI (62% > 27 kg/m²). Total 25(OH) Vit D, Intact PTH (IPTH), ionized Calcium, magnesium, phosphate eIVFG were determined.
Results: serum levels of total 25(OH) Vt D: 89% <30 ng/mL; Deficiency (<14) 25,7%; Insufficiency (≥14 - <30) 63,4%; Sufficiency (≥30 - ≤80) 10,9%. Among categories, differences were highly significant, without association with any of the studied variables.
IPTH had a negative and highly significant correlation with ionized calcium but the inverse correlation with 25(OH) Vit D didn´t reach significance. Secondary hyperparathyroidism due to the deficit wasn’t found.
Conclusions: apparently healthy adults in winter had a very prevalent “Low Vitamin D Status”, without any significant association with the studied variables.
IPTH had different individual responses before distinct levels of 25(OH) Vit D; then it isn´t a good bio-marker of “Vitamin D status”.
Facing these results (in agreement with the bibliography) and the impossibility of a global screening (very costly test) ¿what to do?: ¿prophylactic supplementation at all ages?; ¿how; how much supplement; up to which level? ¿do >30 ng/mL levels protect similarly the osseus and the extra-osseus health? The controversy persists.

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