The first Russian multicenter non-interventional registry Phase III Study of vitamin D deficiency and insufficiency prevalence among adults in Russian Federation

Background. Numerous studies have demonstrated the vitamin D role in the occurrence and development of various diseases. Despite the current treatment and prevention strategies, the problem of vitamin D deficiency prevalence among all the population segments remains unsolved.

Aim. To assess the prevalence of vitamin D deficiency and insufficiency among adult population living in the regions of the Russian Federation located at latitudes from 45° to 70°, as well as to analyze the life quality depending on the 25(OH)D serum level and determine the major associated risk factors for vitamin D deficiency.

Materials and methods. The Russian multicenter, non-interventional, cross-sectional registry study was conducted from October 2021 to March 2022 and included 499 participants.

Results. According to the study, 69.14% of the participants had a vitamin D insufficiency or deficiency. The overall prevalence of vitamin D deficiency in autumn 2021 was higher than in autumn 2020. There were no significant differences in the prevalence of vitamin D deficiency among the Russian Federation regions. The 25(OH)D serum level depending on the sex of the participants was significantly different (p=0.002). Males had vitamin D deficiency in 43.72% of cases, and vitamin D insufficiency and deficiency in 75.7%. At the same time, the prevalence of vitamin D deficiency among the female was lower and amounted to 30.95%, while vitamin D insufficiency and deficiency — in the 62.7% of cases. In addition, vitamin D deficiency was most common in young adults in the age subgroup of 18–25 years (56.10%): the vitamin D insufficiency or deficiency was detected in 81.72% of participants by the statistical weighting methods. Generalized discriminant analysis showed that the biggest contributors to differences between presence and absence of vitamin D insufficiency or deficiency were the following: carbonated beverage consumption, weight, age, education, marital status, and dairy consumption.

Conclusion. Currently, there is a high prevalence of vitamin D deficiency in the Russian Federation, while there is no difference in the 25(OH)D serum level between the northern and southern regions. Male sex and young age (up to 25 years) are a high risk group for developing vitamin D insufficiency and deficiency. A wide range of vitamin D biological functions highlights the necessity of vitamin D insufficiency and deficiency treatment and prevention.

1. Cashman KD. 100 years of vitamin D: Global differences in vitamin D status and dietary intake: a review of the data. Endocr Connect. 2022;11(1):e210282. https://doi.org/10.1530/EC-21-0282

2. Carlberg C, Muñoz A. An update on vitamin D signaling and cancer. Semin Cancer Biol. 2022;79:217-230. https://doi.org/10.1016/j.semcancer.2020.05.018

3. Charoenngam N, Holick MF. Immunologic effects of vitamin D on human health and disease. Nutrients. 2020;12(7):2097. https://doi.org/10.3390/nu12072097

4. Pludowski P, Grant WB, Konstantynowicz J, Holick MF. Editorial: Classic and pleiotropic actions of vitamin D. Front Endocrinol (Lausanne). 2019;(10):217-230. https://doi.org/10.3389/fendo.2019.00341

5. Gallo D, Mortara L, Gariboldi MB, et al. Immunomodulatory effect of vitamin D and its potential role in the prevention and treatment of thyroid autoimmunity: a narrative review. J Endocrinol Invest. 2020;43(4):413-429. https://doi.org/10.1007/s40618-019-01123-5

6. Pigarova EA, Rozhinskaya LY, Belaya JE, et al. Russian Association of Endocrinologists recommendations for diagnosis, treatment and prevention of vitamin D deficiency in adults. Problems of Endocrinology. 2016;62(4):60-84. (In Russ.). https://doi.org/10.14341/probl201662460-84

7. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline [published correction appears in J Clin Endocrinol Metab. 2011;96(12):3908]. J Clin Endocrinol Metab. 2011;96(7):1911-1930. https://doi.org/10.1210/jc.2011-0385

8. Shmakin AB. Development of climatological research at the Institute of geography of the Russian Academy of Sciences. Izvestiya RAN. 2008;(5):95-105 (In Russ.).

9. Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266-281. https://doi.org/10.1056/NEJMra070553

10. Huotari A, Herzig K-H. Vitamin D and living in northern latitudes—an endemic risk area for vitamin D deficiency. Int J Circumpolar Health. 2008;67(2-3):164-178. https://doi.org/10.3402/ijch.v67i2-3.18258

11. Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium, Ross AC, Taylor CL, Yaktine AL, Del Valle HB, eds. Dietary Reference Intakes for Calcium and Vitamin D. Washington (DC): National Academies Press (US); 2011.

12. Suplotova LA, Avdeeva VA, Pigarova EA, et al. The first Russian multicenter non-interventional registry study to study the incidence of vitamin D deficiency and insufficiency in Russian Federation. Therapeutic Archive. 2021;93(10):1209-1216. (In Russ.). https://doi.org/10.26442/00403660.2021.10.201071]

13. Carpagnano GE, Di Lecce V, Quaranta VN, et al. Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19. J Endocrinol Invest. 2021;44(4):765-771. https://doi.org/10.1007/s40618-020-01370-x

14. Kaya MO, Pamukçu E, Yakar B. The role of vitamin D deficiency on COVID-19: a systematic review and meta-analysis of observational studies. Epidemiol Health. 2021;(43):e2021074. https://doi.org/10.4178/epih.e2021074

15. Pereira M, Dantas Damascena A, Galvão Azevedo LM, et al. Vitamin D deficiency aggravates COVID-19: systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2022;62(5):1308-1316. https://doi.org/10.1080/10408398.2020.1841090

16. Entrenas Castillo M, Entrenas Costa LM, Vaquero Barrios JM, et al. Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study. J Steroid Biochem Mol Biol. 2020;(203):105751. https://doi.org/10.1016/j.jsbmb.2020.105751

17. Alcala-Diaz JF, Limia-Perez L, Gomez-Huelgas R, et al. Calcifediol treatment and hospital mortality due to COVID-19: A cohort study. Nutrients. 2021;13(6):1760. https://doi.org/10.3390/nu13061760

18. Gönen MS, Alaylıoğlu M, Durcan E, et al. Rapid and effective vitamin d supplementation may present better clinical outcomes in COVID-19 (SARS-CoV-2) patients by altering serum INOS1, IL1B, IFNg, cathelicidin-LL37, and ICAM1. Nutrients. 2021;13(11):4047. https://doi.org/10.3390/nu13114047

19. Sabico S, Enani MA, Sheshah E, et al. Effects of a 2-Week 5000 IU versus 1000 IU vitamin D3 supplementation on recovery of symptoms in patients with mild to moderate Covid-19: A randomized clinical trial. Nutrients. 2021;13(7):2170. https://doi.org/10.3390/nu13072170

20. Hewison M, Freeman L, Hughes SV, et al. Differential regulation of vitamin D receptor and its ligand in human monocyte-derived dendritic cells. J Immunol. 2003;170(11):5382-5390. https://doi.org/10.4049/jimmunol.170.11.538

21. Ginde AA, Mansbach JM, Camargo CA Jr. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2009;169(4):384-390. https://doi.org/10.1001/archinternmed.2008.560

22. Доступно по: http://www.aqol.com.au/choice-of-aqol-instrument/58.html. Ссылка активна на 19.04.2022.

23. Sergienko VI, Bondareva IB. Matematicheskaia statistika v klinicheskikh issledovaniiakh. Moscow: GEOSTAR-Media; 2006. (In Russ.).

24. Federal’naia sluzhba gosudarstvennoi statistiki. Chislennost’ naseleniia Rossiiskoi Federatsii po polu i vozrastu. (In Russ.). Доступно по: https://rosstat.gov.ru/compendium/document/13284. Ссылка активна 09.04.2023.

25. Pigarova EA, Petrushkina AA. Non-classical effects of vitamin D. Osteoporosis and Bone Diseases. 2017;20(3):90-101. (In Russ.). https://doi.org/10.14341/osteo2017390-101

26. Bikle DD. Vitamin D: Production, Metabolism and Mechanisms of Action. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext. South Dartmouth (MA): MDText.com, Inc.; 2021.

27. Buralkina NA, Arutyunova EE, Vlasova GA. Global vitamin D status problems: causes, pathogenetic mechanisms, treatment, prevention measures. Medical Council. 2018;(12):152-158. (In Russ.)]. https://doi.org/10.21518/2079-701X-2018-12-152-158

28. Garland CF, Gorham ED, Mohr SB, Garland FC. Vitamin D for cancer prevention: Global perspective. Ann Epidemiol. 2009;19(7):468-483. https://doi.org/10.1016/j.annepidem.2009.03.021

29. Yetley EA. Assessing the vitamin D status of the US population. Am J Clin Nutr. 2008;88(2):558S-564S. https://doi.org/10.1093/ajcn/88.2.558S

30. Karonova TL, Andreeva AT, Golovatyuk KA, et al. SARS-CoV-2 morbidity depending on vitamin D status. Problems of Endocrinology. 2021;67(5):20-28. (In Russ.). doi: https://doi.org/10.14341/probl12820

31. Karonova TL, Andreeva AT, Golovatuk KA, et al. Low 25(OH)D Level Is Associated with Severe Course and Poor Prognosis in COVID-19. Nutrients. 2021;13(9):3021. https://doi.org/10.3390/nu13093021

32. Elamir YM, Amir H, Lim S, et al. A randomized pilot study using calcitriol in hospitalized COVID-19 patients. Bone. 2022;(154):116175. https://doi.org/10.1016/j.bone.2021.116175