Vitamin D status among adolescents in Kuwait: a cross-sectional study

Abdullah Al-Taiar 1, Abdur Rahman 2, Reem Al-Sabah 1, Lemia Shaban 2, Anwar Al-Harbi 3

Affiliations

01 August 2018

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doi: 10.1136/bmjopen-2017-021401

Abstract

Objectives: In Kuwait, as in many Arab states in the Gulf region, there are limited data on the prevalence of vitamin D deficiency among healthy adolescents. This study aimed to estimate the prevalence of vitamin D deficiency in a nationally representative sample of adolescents and investigate factors associated with vitamin D status.

Methods: A cross-sectional study was conducted on 1416 adolescents aged 11-16 years, who were randomly selected from middle schools in all governorates of Kuwait. Data were collected from parents through self-administered questionnaire and from adolescents through face-to-face interview. Vitamin D was measured using liquid chromatography-tandem mass spectrometry. Logistic regression was used to investigate the independent factors associated with vitamin D status.

Results: The prevalence of vitamin D deficiency was 81.21% (95% CI 71.61% to 90.81%), while severe deficiency was 39.48%. Only 3.60% of adolescents were vitamin D-sufficient. The prevalence of vitamin D deficiency was significantly higher among girls compared with boys (91.69% vs 70.32%; p<0.001). There was a significant inverse correlation between vitamin D and parathyroid hormone (Spearman correlation=-0.35; p<0.001). In the final model, gender, age, governorate, parental education, body mass index, vitamin D supplement and the number of times adolescents walk to schools per week were all significantly related to vitamin D deficiency.

Conclusion: High prevalence of vitamin D deficiency was noted among adolescents in Kuwait despite the abundant sunshine, which may reflect strong sun avoidance behaviour. Adequate outdoor daytime activities should be encouraged especially for girls. We call for locally tailored guidelines for vitamin D supplement in which girls should have a higher dose compared with boys.

Keywords: adolescents; kuwait; public health; school children; vitamin D.

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1 Parathyroid hormone (PTH) with serum 25-hydroxyvitamin D (25-OH-D) concentration. Individuals above the horizontal line (PTH ≥65.0 ng/L) are adolescents with secondary hyperthyroidism. Vertical lines represent the 25-OH-D cut-off used to define vitamin D deficiency, insufficiency and sufficiency (seven participants with 25-OH-D >150 nmol/L were omitted).

Figure 1 Parathyroid hormone (PTH) with serum 25-hydroxyvitamin D (25-OH-D) concentration. Individuals above the horizontal line (PTH ≥65.0 ng/L) are adolescents with secondary hyperthyroidism. Vertical lines represent the 25-OH-D cut-off used to define vitamin D deficiency, insufficiency and sufficiency (seven participants with 25-OH-D >150 nmol/L were omitted).

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KMEL References

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