Vitamin D, parathormone and associated minerals among students in Zagazig district, Sharkia Governorate, Egypt

Aim: To determine the prevalence of vitamin D deficiency and associated factors among students of age 13 - 18 years. Methods: Design: Community-based cross sectional survey. Setting: Two schools were selected using multistage sampling techniques. Sampling: Cluster sampling of all enrolled students (550 students). Outcome Measures: Serum levels of 25-hydroxyvitamin D (25 OHD), parathyroid hormone and calcium. Data was collected about nutritional intake, physical activity and lifestyle variables that are potential risk factors for hypovitaminosis D. Results: Hypovitaminosis D prevalence was 23.8 %, of which 5.3 % was deficiency and 18.5 % insufficiency. Serum 25 OHD levels inversely correlated with parathyroid hormone levels (r = -0.206, P = 0.00). Low calcium and ionized calcium levels were 40.6 % and 45.9 %, respectively, and significantly correlated with vitamin D levels. Female students have significantly higher levels of hypovitaminosis D compared to males (29.3 % to 15.0 %, respectively) and the level of vitamin D significantly improved with increased age. Exposure to sun had a significant effect on vitamin D levels, and physical activity, soft drink consumption and smoking did not. Multinomial regression analysis revealed that age, sun exposure and Ca level were the only significant independent predictors of hypovitaminosis D among the studied group. Conclusion: Our findings revealed that hypovitaminosis D is a prevalent health problem in adolescents, especially girls, who were at higher risk, and increased age and sun exposure improved vitamin D status among the studied group. There is therefore a need to consider vitamin D supplementation for school children together with increased awareness through a health education program.