Background: Vitamin D is best known as a key regulator of bone metabolism and calcium and phosphate homeostasis. This study aimed to assess the effect of different factors on the five-year changes in serum vitamin D concentration among older adults. Methods: This cohort study was conducted on adults aged ≥60 years living in Amirkola, in the North of Iran, from 2012 to 2017. Serum 25-hydroxyvitamin D (25-OH vitamin D) concentrations of <20, 20-29.99, and ≥30 ng/mL, respectively, were used to designate vitamin D deficiency, insufficiency, and sufficiency. Any variation between the second and baseline values of the 25-OH vitamin D concentration was reported as a five-year difference. Data were analyzed using SPSS version 17.0, and Chi square, t test, one-way ANOVA, and Tukey HSD post hoc tests were employed. P values less than 0.05 were considered statistically significant. Results: The mean serum concentration of 25-OH vitamin D at baseline and follow-up examination in 1011 individuals was 34.68±33.18 and 23.88±14.91, respectively (P<0.001). Following a five-year follow-up, vitamin D deficiency, insufficiency, and sufficiency were found in 452 (44.7%), 334 (33.0%), and 225 (22.3%) cases, respectively. The reduction in serum 25-OH vitamin D concentration after five years was significantly influenced by the administration of vitamin D (P=0.013) and calcium (P=0.007) supplements, serum profile of parathyroid hormone (PTH) (P=0.010), calcium (P=0.021), and phosphorous (P=0.021). However, age, sex, body mass index, metabolic syndrome, and physical activity had no significant impact (P>0.05). Conclusion: Regardless of age, sex, body mass index, metabolic syndrome, or physical activity, the mean serum concentration of vitamin D decreased over a five-year follow-up. |
- Xu Y, Baylink DJ, Chen CS, Reeves ME, Xiao J, Lacy C, et al. The importance of vitamin d metabolism as a potential prophylactic, immunoregulatory and neuroprotective treatment for COVID-19. J Transl Med. 2020;18:322. doi: 10.1186/s12967-020-02488-5. PubMed PMID: 32847594; PubMed Central PMCID: PMCPMC7447609.
- Sultan S, Taimuri U, Basnan SA, Ai-Orabi WK, Awadallah A, Almowald F, et al. Low Vitamin D and Its Association with Cognitive Impairment and Dementia. J Aging Res. 2020;2020:6097820. doi: 10.1155/2020/6097820. PubMed PMID: 32399297; PubMed Central PMCID: PMCPMC7210535.
- Lee DH, Chon J, Kim Y, Seo YK, Park EJ, Won CW, et al. Association between vitamin D deficiency and cognitive function in the elderly Korean population: A Korean frailty and aging cohort study. Medicine (Baltimore). 2020;99:e19293. doi: 10.1097/MD.0000000000019293. PubMed PMID: 32080146; PubMed Central PMCID: PMCPMC7034713.
- Yang T, Wang H, Xiong Y, Chen C, Duan K, Jia J, et al. Vitamin D Supplementation Improves Cognitive Function Through Reducing Oxidative Stress Regulated by Telomere Length in Older Adults with Mild Cognitive Impairment: A 12-Month Randomized Controlled Trial. J Alzheimers Dis. 2020;78:1509-18. doi: 10.3233/JAD-200926. PubMed PMID: 33164936.
- Kweder H, Eidi H. Vitamin D deficiency in elderly: Risk factors and drugs impact on vitamin D status. Avicenna J Med. 2018;8:139-46. doi: 10.4103/ajm.AJM_20_18. PubMed PMID: 30319955; PubMed Central PMCID: PMCPMC6178567.
- Hajhashemy Z, Shahdadian F, Moslemi E, Mirenayat FS, Saneei P. Serum vitamin D levels in relation to metabolic syndrome: A systematic review and dose-response meta-analysis of epidemiologic studies. Obes Rev. 2021;22:e13223. doi: 10.1111/obr.13223. PubMed PMID: 33829636.
- Roth DE, Abrams SA, Aloia J, Bergeron G, Bourassa MW, Brown KH, et al. Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low- and middle-income countries. Ann N Y Acad Sci. 2018;1430:44-79. doi: 10.1111/nyas.13968. PubMed PMID: 30225965; PubMed Central PMCID: PMCPMC7309365.
- Boettger SF, Angersbach B, Klimek CN, Wanderley ALM, Shaibekov A, Sieske L, et al. Prevalence and predictors of vitamin D-deficiency in frail older hospitalized patients. BMC Geriatr. 2018;18:219. doi: 10.1186/s12877-018-0919-8. PubMed PMID: 30236071; PubMed Central PMCID: PMCPMC6148775.
- Vatandost S, Jahani M, Afshari A, Amiri MR, Heidarimoghadam R, Mohammadi Y. Prevalence of vitamin D deficiency in Iran: A systematic review and meta-analysis. Nutr Health. 2018;24:269-78. doi: 10.1177/0260106018802968. PubMed PMID: 30296903.
- Alipour M, Hosseini S, Saadat P, Bijani A. The relationship between chronic musculoskeletal pain and vitamin D deficiency in the elderly population of Amirkola, Iran. Journal of Babol University of Medical Sciences. 2015;17:7-14. doi: 10.22088/jbums.17.10.7.
- Hosseini S, Ahmadi Ahangar A, Ghanbari N, Bijani A. Prevalence of falls and its association with serum vitamin d levels in the elderly population of Amirkola city. Journal of Babol University of Medical Sciences. 2016;18:20-8.
- Chai B, Gao F, Wu R, Dong T, Gu C, Lin Q, et al. Vitamin D deficiency as a risk factor for dementia and Alzheimer’s disease: an updated meta-analysis. BMC Neurol. 2019;19:284. doi: 10.1186/s12883-019-1500-6. PubMed PMID: 31722673; PubMed Central PMCID: PMCPMC6854782.
- Orces C, Lorenzo C, Guarneros JE. The Prevalence and Determinants of Vitamin D Inadequacy among U.S. Older Adults: National Health and Nutrition Examination Survey 2007-2014. Cureus. 2019;11:e5300. doi: 10.7759/cureus.5300. PubMed PMID: 31579639; PubMed Central PMCID: PMCPMC6768617.
- Lee SJ, Lee EY, Lee JH, Kim JE, Kim KJ, Rhee Y, et al. Associations of serum 25-hydroxyvitamin D with metabolic syndrome and its components in elderly men and women: the Korean Urban Rural Elderly cohort study. BMC Geriatr. 2019;19:102. doi: 10.1186/s12877-019-1118-y. PubMed PMID: 30975093; PubMed Central PMCID: PMCPMC6458686.
- Martins JS, Palhares MO, Teixeira OC, Gontijo Ramos M. Vitamin D Status and Its Association with Parathyroid Hormone Concentration in Brazilians. J Nutr Metab. 2017;2017:9056470. doi: 10.1155/2017/9056470. PubMed PMID: 28265467; PubMed Central PMCID: PMCPMC5318626.
- Bijani A, Ghadimi R, Mikaniki E, Kheirkhah F, Mozaffarpur SA, Motallebnejad M, et al. Cohort Profile Update: The Amirkola Health and Ageing Project (AHAP). Caspian J Intern Med. 2017;8:205-12. doi: 10.22088/cjim.8.3.205. PubMed PMID: 28932373; PubMed Central PMCID: PMCPMC5596192.
- Hosseini SR, Cumming RG, Kheirkhah F, Nooreddini H, Baiani M, Mikaniki E, et al. Cohort profile: the Amirkola Health and Ageing Project (AHAP). Int J Epidemiol. 2014;43:1393-400. doi: 10.1093/ije/dyt089. PubMed PMID: 23918798.
- Holick MF. Vitamin D status: measurement, interpretation, and clinical application. Ann Epidemiol. 2009;19:73-8. doi: 10.1016/j.annepidem.2007.12.001. PubMed PMID: 18329892; PubMed Central PMCID: PMCPMC2665033.
- Thomas GN, Ho SY, Janus ED, Lam KS, Hedley AJ, Lam TH, et al. The US National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) prevalence of the metabolic syndrome in a Chinese population. Diabetes Res Clin Pract. 2005;67:251-7. doi: 10.1016/j.diabres.2004.07.022. PubMed PMID: 15713358.
- New England Research Institutes (NERI). PASE: Physical Activity Scale for the Elderly: Administration and Scoring Instruction Manual. Watertown: New England Research Institutes; 1991.
- Hatami O, Aghabagheri M, Kahdouei S, Nasiriani K. Psychometric properties of the Persian version of the Physical Activity Scale for the Elderly (PASE). BMC Geriatr. 2021;21:383. doi: 10.1186/s12877-021-02337-0. PubMed PMID: 34162345; PubMed Central PMCID: PMCPMC8220717.
- Gallagher JC. Vitamin D and aging. Endocrinol Metab Clin North Am. 2013;42:319-32. doi: 10.1016/j.ecl.2013.02.004. PubMed PMID: 23702404; PubMed Central PMCID: PMCPMC3782116.
- Aspell N, Laird E, Healy M, Shannon T, Lawlor B, O’Sullivan M. The Prevalence and Determinants of Vitamin D Status in Community-Dwelling Older Adults: Results from the English Longitudinal Study of Ageing (ELSA). Nutrients. 2019;11. doi: 10.3390/nu11061253. PubMed PMID: 31159411; PubMed Central PMCID: PMCPMC6627050.
- Wei J, Zhu A, Ji JS. A Comparison Study of Vitamin D Deficiency among Older Adults in China and the United States. Sci Rep. 2019;9:19713. doi: 10.1038/s41598-019-56297-y. PubMed PMID: 31873182; PubMed Central PMCID: PMCPMC6928152.
- Jolliffe DA, Hanifa Y, Witt KD, Venton TR, Rowe M, Timms PM, et al. Environmental and genetic determinants of vitamin D status among older adults in London, UK. J Steroid Biochem Mol Biol. 2016;164:30-5. doi: 10.1016/j.jsbmb.2016.01.005. PubMed PMID: 26776442.
- Wyskida M, Wieczorowska-Tobis K, Chudek J. Prevalence and factors promoting the occurrence of vitamin D deficiency in the elderly. Postepy Hig Med Dosw (Online). 2017;71:198-204. doi: 10.5604/01.3001.0010.3804. PubMed PMID: 28345527.
- Kader S, Comaklı H, Tekindal MA. Evaluation of serum vitamin D levels according to gender and age at Karapınar City: a follow-up study from Turkey. Dubai Medical Journal. 2019;2:141-5. doi: 10.1159/000503899.
- Kim KT, Kang KC, Shin DE, Lee SH, Lee JH, Kwon TY. Prevalence of Vitamin D Deficiency and Its Association With Metabolic Disease in Korean Orthopedic Patients. Orthopedics. 2015;38:e898-903. doi: 10.3928/01477447-20151002-57. PubMed PMID: 26488785.
- Cheng Q, Du Y, Hong W, Tang W, Li H, Chen M, et al. Factors associated to serum 25-hydroxyvitamin D levels among older adult populations in urban and suburban communities in Shanghai, China. BMC Geriatr. 2017;17:246. doi: 10.1186/s12877-017-0632-z. PubMed PMID: 29065856; PubMed Central PMCID: PMCPMC5654067.
- Savastano S, Barrea L, Savanelli MC, Nappi F, Di Somma C, Orio F, et al. Low vitamin D status and obesity: Role of nutritionist. Rev Endocr Metab Disord. 2017;18:215-25. doi: 10.1007/s11154-017-9410-7. PubMed PMID: 28229265.
- Vanlint S. Vitamin D and obesity. Nutrients. 2013;5:949-56. doi: 10.3390/nu5030949. PubMed PMID: 23519290; PubMed Central PMCID: PMCPMC3705328.
- Caravaca F, Caravaca-Fontan F, Azevedo L, Luna E. Changes in renal function after discontinuation of vitamin D analogues in advanced chronic kidney disease. Nefrologia (Engl Ed). 2018;38:179-89. doi: 10.1016/j.nefro.2017.05.012. PubMed PMID: 28676189.
- Kupisz-Urbanska M, Pludowski P, Marcinowska-Suchowierska E. Vitamin D Deficiency in Older Patients-Problems of Sarcopenia, Drug Interactions, Management in Deficiency. Nutrients. 2021;13. doi: 10.3390/nu13041247. PubMed PMID: 33920130; PubMed Central PMCID: PMCPMC8069639.
- Preiss D, Sattar N. Research digest: vitamin D supplementation. Lancet Diabetes Endocrinol. 2019;7:91. doi: 10.1016/S2213-8587(19)30007-5. PubMed PMID: 30683222.
- Fernandes MR, Barreto WDRJ. Association between physical activity and vitamin D: A narrative literature review. Rev Assoc Med Bras (1992). 2017;63:550-6. doi: 10.1590/1806-9282.63.06.550. PubMed PMID: 28876433.
- Amrein K, Scherkl M, Hoffmann M, Neuwersch-Sommeregger S, Kostenberger M, Tmava Berisha A, et al. Vitamin D deficiency 2.0: an update on the current status worldwide. Eur J Clin Nutr. 2020;74:1498-513. doi: 10.1038/s41430-020-0558-y. PubMed PMID: 31959942; PubMed Central PMCID: PMCPMC7091696.
- Borel P, Caillaud D, Cano NJ. Vitamin D bioavailability: state of the art. Crit Rev Food Sci Nutr. 2015;55:1193-205. doi: 10.1080/10408398.2012.688897. PubMed PMID: 24915331.
- Lan SH, Lai CC, Chang SP, Lu LC, Hung SH, Lin WT. Vitamin D supplementation and the outcomes of critically ill adult patients: a systematic review and meta-analysis of randomized controlled trials. Sci Rep. 2020;10:14261. doi: 10.1038/s41598-020-71271-9. PubMed PMID: 32868842; PubMed Central PMCID: PMCPMC7459294.
- Goltzman D, Mannstadt M, Marcocci C. Physiology of the Calcium-Parathyroid Hormone-Vitamin D Axis. Front Horm Res. 2018;50:1-13. doi: 10.1159/000486060. PubMed PMID: 29597231.
|