[01] Hamid Yahya Husain, Primary Health Care / Dubai Health Authority, Dubai, UAE. [02] Zekeria Kareem, Primary Health Care / Dubai Health Authority, Dubai, UAE. [03] Waleed Al Faisal, Primary Health Care / Dubai Health Authority, Dubai, UAE.

Vitamin D deficiency is the most common nutritional deficiency worldwide in both children and adults which lead to increases the risk of many chronic diseases, including cancer, autoimmune diseases, type 2 diabetes, heart disease and hypertension, and infectious diseases, objective of the study is to study the prevalence of Vit D Insufficiency and Deficiency among Adult cohort in Dubai, to study the epidemiological profile and associated factors Methodology: a cross sectional study carried out on (80) Adult patient, age rage (15-70 y) randomly selected from Vitamin deficiency and insufficiency cohorts registered and attending primary health care facilities at Dubai health authority, full socioe demographic and clinical data has been collected through data collection interview questionnaire, patients follow up has been extended for up to one year in relation to lab investigation follow up, vitamin D therapy, health education, life style intervention and physical examination (operational definitions of variables, inclusion-exclusion criteria, scale of measurement and ethical considerations has been addressed properly throughout the research course: Results: The study showed that about 75% of the total participant showed vitamin D insufficiency and 25% of the total sample showed vitamin D deficiency means one third of abnormal vitamin D level was deficiency below (<10) and two third are between (10-30). The most affected age segment was the age class45-54 consist about 29% of the total sample and the least affected age group was 915-24 about (7%). The study showed that about 67.5% of the total sample with abnormal serum Vitamin D level was among females and 32.5% of them were males). Among affected females, the study revealed that about 28% were shown vitamin D insufficiency and 72% showed vitamin D Deficiency. About 91.25% of the abnormal serum Vitamin D level was shown to be UAE nationals and 9.75% were shown to be expatriate. Vitamin D deficiency was more among cohorts of BMI within range of (26-30) overweight group which showed about 53% followed by BMI (>30) obese group (37.75%) while it was the least among normal BMI cohorts about 21.25%. The study showed that only 22.5% of the total sample size was having a history of exposure to health education and awareness about the diseases.

Vit D, Deficiency, Patterns, Clinical Audit

[01] Pfeifer M, Begerow B, Minne HW, Abrams C, Nachtigall D, Hansen C. Effects of a short-term vitamin D and calcium supplementation on body sway and secondary hyperparathyroidism in elderly women. Journal of Bone and Mineral Research. 2000; 15(6):1113–1118. [PubMed]. [02] Pfeifer M, Begerow B, Minne HW, Suppan K, Fahrleitner-Pammer A, Dobnig H. Effects of a long-term vitamin D and calcium supplementation on falls and parameters of muscle function in community-dwelling older individuals. Osteoporosis International. 2009; 20(2):315–322. [PubMed]. [03] Lips P. Interaction between vitamin D and calcium. Scandinavian Journal of Clinical and Laboratory Investigation, Supplementum. 2012; 243:60–64. [PubMed]. [04] Bischoff-Ferrari HA, Willett WC, Wong JB, et al. Prevention of nonvertebral fractures with oral vitamin D and dose dependency: a meta-analysis of randomized controlled trials. Archives of Internal Medicine. 2009; 169(6):551–561. [PubMed]. [05] Khosla S. What do we tell our patients about calcium and vitamin D supplementation? Journal of Clinical Endocrinology and Metabolism. 2011; 96(1):69–71. [PubMed]. [06] Milazzo L, Mazzali C, Bestetti G, et al. Liver-related factors associated with low vitamin D levels in HIV and HIV/HCV coinfected patients and comparison to general population. Current HIV Research. 2011;9(3):186–193. [PubMed]. [07] Tom D. Thacher, MD and Bart L. Clarke, MD, Vitamin D Insufficiency, Mayo Clin Proc. 2011 Jan; 86(1): 50–60. doi: 10.4065/mcp.2010.0567PMCID: PMC3012634. [08] Zamora SA, Rizzoli R, Belli DC, Slosman DO, Bonjour JP. Vitamin D supplementation during infancy is associated with higher bone mineral mass in prepubertal girls. J Clin Endocrinol Metab. 1999;84(12):4541-4544 [PubMed]. [09] Cranney A, Horsley T, O'Donnell S, et al. Effectiveness and safety of vitamin D in relation to bone health. Evidence Report/Technology Assessment No 158 Published August 2007. AHRQ Publication No 07-E013 Rockville, MD: Agency for Healthcare Research and Quality; Accessed November 8, 2010. [10] nonskeletal effects of vitamin D has been increasing since the discovery of vitamin D receptors and the 1α-hydroxylase enzyme in multiple tissues, including cells of the pancreas, immune system, macrophages, vascular endothelium, stomach, epidermis, colon, and placenta6. [11] 40. Bischoff-Ferrari HA, Kiel DP, Dawson-Hughes B, et al. Dietary calcium and serum 25-hydroxyvitamin D status in relation to BMD among U.S. adults. J Bone Miner Res. 2009;24(5):935-942 [PMC free article] [PubMed]. [12] Ginde AA, Scragg R, Schwartz RS, Camargo CA., Jr Prospective study of serum 25-hydroxyvitamin D level, cardiovascular disease mortality, and all-cause mortality in older U.S. adults. J Am Geriatr Soc. 2009;57(9):1595-1603 [PubMed]. [13] Pittas AG, Dawson-Hughes B, Li T, et al. Vitamin D and calcium intake in relation to type 2 diabetes in women. Diabetes Care. 2006;29(3):650-656 [PubMed]. [14] . Litonjua AA. Childhood asthma may be a consequence of vitamin D deficiency. Curr Opin Allergy Clin Immunol. 2009;9(3):202-207 [PMC free article] [PubMed]. [15] 74. Wjst M, Dold S. Genes, factor X, and allergens: what causes allergic diseases? Allergy. 1999; 54(7):757-759 [PubMed]. [16] 75. Brehm JM, Celedon JC, Soto-Quiros ME, et al. Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica. Am J Respir Crit Care Med. 2009;179(9):765-771 [PMC free article] [PubMed] [17] Robin M. Daly Claudia Gagnon. Zhong X. Lu Dianna J. Maglian, David W. Dunstan, Ken A. Sikaris, Paul Z. Zimmet, Peter R. Ebeling and Jonathan E. Shaw. Clinical Endocrinology (2012) 77, 26–3. [18] Al-Dabhani K1, Tsilidis KK1, 2, Murphy N1, 3, Ward HA1, Elliott P1, 4, Riboli E1, Gunter M3, Tzoulaki INutr Diabetes. Prevalence of vitamin D deficiency and association with metabolic syndrome in a Qatari population 2017 Apr 10;7(4):e263. doi: 10.1038/nutd.2017.14. [19] Hussain A, Alkhenizan A, El Shaker M, Raef H, Gabr A. Increasing trends and significance of hypovitaminosis D: a population-based study in the Kingdom of Saudi Arabia. Arch Osteoporos 2014; 9: 1–5. [PubMed]. [20] Golbahar J, Al-Saffar N, Altayab Diab D, Al-Othman S, Darwish A, Al-Kafaji G. Predictors of vitamin D deficiency and insufficiency in adult Bahrainis: a cross-sectional study. Public Health Nutr 2014; 17: 732–738. [PubMed]. [21] Hoteit M, Al-Shaar L, Yazbeck C, Bou Sleiman M, Ghalayini T, Fuleihan GE-H. Hypovitaminosis D in a sunny country: time trends, predictors, and implications for practice guidelines. Metabolism 2014; 63: 968–978. [PubMed]. [22] Cameron, A. J., Welborn, T. A., Zimmet, P. Z. et al. (2003) Overweight and obesity in Australia: the 1999–2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Medical Journal of Australia, 178, 427–432. [23] Gagnon C, Lu ZX, Magliano DJ, Dunstan DW, Shaw JE, Zimmet PZ et al. Low serum 25-hydroxyvitamin D is associated with increased risk of the development of the metabolic syndrome at five years: results from a national, population-based prospective study (The Australian Diabetes, Obesity and Lifestyle Study: AusDiab). J Clin Endocrinol Metab 2012; 97: 1953–1961. [PubMed]. [24] Hyppönen E, Boucher BJ, Berry DJ, Power C. 25-hydroxyvitamin D, IGF-1, and metabolic syndrome at 45 years of age A cross-sectional study in the 1958 british birth cohort. Diabetes 2008; 57: 298–305. [PubMed]. [25] Sadiya A, Ahmed SM, Skaria S, Abusnana S. Vitamin D status and its relationship with metabolic markers in persons with obesity and type 2 diabetes in the UAE: a cross-sectional study. J Diabetes Res 2014; 2014: 869307. [PMC free article] [PubMed]. [26] Ardawi M-SM, Sibiany AM, Bakhsh TM, Qari MH, Maimani AA. High prevalence of vitamin D deficiency among healthy Saudi Arabian men: relationship to bone mineral density, parathyroid hormone, bone turnover markers, and lifestyle factors. Osteoporosis Int 2011; 23: 675–686. [PubMed]. [27] Fung GJ, Steffen LM, Zhou X, Harnack L, Tang W, Lutsey PL et al. Vitamin D intake is inversely related to risk of developing metabolic syndrome in African American and white men and women over 20 y: the coronary artery risk development in young adults study. Am J Clin Nutr 2012; 96: 24–29. [PMC free article] [PubMed]. [28] Lu L, Yu Z, Pan A, Hu FB, Franco OH, Li H et al. Plasma 25-hydroxyvitamin D concentration and metabolic syndrome among middle-aged and elderly Chinese individuals. Diabetes Care 2009; 32: 1278–1283. [PMC free article] [PubMed]. [29] Moy F-M, Bulgiba A. High prevalence of vitamin D insufficiency and its association with obesity and metabolic syndrome among Malay adults in Kuala Lumpur, Malaysia. BMC Public Health 2011; 11: 1–7. [PMC free article] [PubMed]. [30] Majumdar V, Nagaraja D, Christopher R. Vitamin D status and metabolic syndrome in Asian Indians. Int J Obes 2011; 35: 1131–1134. [PubMed]. [31] Reis JP, von Mühlen D, Kritz-Silverstein D, Wingard DL, Barrett-Connor E. Vitamin D, parathyroid hormone levels, and the prevalence of metabolic syndrome in community-dwelling older adults. Diabetes Care 2007; 30: 1549–1555. [PubMed]. [32] Oosterwerff MM, Eekhoff EMW, Heymans MW, Lips P, van Schoor NM. Serum 25-hydroxyvitamin D levels and the metabolic syndrome in older persons: a population-based study. Clin Endocrinol 2011; 75: 608–613. [PubMed]. [33] Mithal, A., Wahl, D. A., Bonjour, J. P. et al. (2009) Global vitamin D status and determinants of hypovitaminosis D. Osteoporosis International, 20, 1807–1820. [34] Rockell, J. E., Skeaff, C. M., Williams, S. M. et al. (2006) Serum 25-hydroxyvitamin D concentrations of New Zealanders aged 15 years and older. Osteoporosis International, 17, 1382–1389. [35] Holick, M. F. (2007) Vitamin D deficiency. New England Journal of Medicine, 357, 266–281. 33 MacLaughlin, J. & Holick, M. F. (1985) Aging decreases the capacity of human skin to produce vitamin D3. Journal of Clinical Investigation, 76, 1536–1538. [36] Looker, A. C., Dawson-Hughes, B., Calvo, M. S. et al. (2002) Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. Bone, 30, 771–777. 8 Greene-Finestone, L. S., Berger, C., de Groh, M. et al. (2011) 25Hydroxyvitamin D in Canadian adults: biological, environmental, and behavioral correlates. Osteoporosis International, 22, 1389–1399.