Background Vitamin D deficiency is attributed to several causes including the lack of adequate exposure to sunlight due to the clothing styles that hinder the effect of UVB on skin synthesis of the vitamin.
Objectives Our objective here was to determine status of the plasma (25-OHD) in women with different dressing style residing in a country known for its year-round sunny environment.
Methods 255 women aged between 15-87 years who were not receiving vitamin D supplement underwent assay for the vitamin using chemiluminscent microparticle immunoassay of total 25 hydroxy- vitamin D [(25-OH)D]. Their demography was diverse as 78% were Middle Eastern and North African individuals of an Arab extraction by large and the rest were heterogeneous. 200 (80.5%) were either fully covered-including the face using Hijab or neqab (96; Group 1) or face-exposed (104; Group 2). The remaining 55 were western dressed women (Group 3). Their mean age was (44.8±14.6 years) and was not different among the 3 groups respectively (47±15.6, 46.3±14.3 and 41.8±13 years), p= NS. 51 women in group 1 and 68 in group 2 indicated their adherence to their dressing style for a mean of 24.1±15.6 and 20.5±10.3 years respectively, p=0.14. All in group 3 lived in UAE for >2 years.
Results The prevalence of hypovitaminosis D (deficient or insufficient; <30 ng/ml) was 90.5% with mean of 19.3±9.35 in the entire cohort and in 90.5, 94 & 83% with the mean value of the vitamin was 19.4±7.8, 17.4±8.2 & 22. 5±12.5 ng/ml in the 3 groups respectively. The significant differences were observed only between the prevalence in group 2 vs. group 3 (p=0.043, OR 1.701 & 95% CI 0.702-5.093) and their mean value too, p=0.002. Values of vitamin deficiency (<12 ng/ml) were observed in 39 (15%). The prevalence and mean values were not different in the 3 groups (11.5, 21 & 11% and 9.38±2.5, 9.07±2.5 & 8.75±1.5) respectively, p=NS.
Interestingly, those indicated the longevity of their dress style among group 2 (face-exposed) had a lower mean of 25 (OH) D (16.6±5.1 vs.19.9±7.95 ng/ml) of others in group 1 who were fully covered, p=0.008. Osteoporosis (<-2.5 SD on DXA) was observed in 45/205 (22%), (24.5, 22.5 & 14.5%) of patients in the 3 groups respectively P=NS. However, those patients were older than the average age of the patients (menopause or post menopausal age).
Conclusions In these women of diverse demography, hypovitaminosis D 3 was alarmingly high in the three groups irrespective to their dressing style with the highest surprisingly being in the covered but face-exposed women. The dress style therefore, should not be used as pretext for the diagnosis of hypovitaminosis D before other probable etiological factors are examined or considered. There is more to the problem among the women in this community than just a simple pattern and longevity of dressing style. Despite such high prevalence of hypovitaminosis D, its contribution to osteoporosis however, was less impressive to that of the postmenopausal age.
Disclosure of Interest None Declared
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