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Vitamin D deficiency of the twenties in Korea : Based on Korea National Health and Nutrition Examination Survey V

한국 20대의 비타민 D 결핍 관련요인 분석 : 제 5기 국민건강영양조사를 이용하여

  • Joo, Mi-Hyun (Department of Public Health, Graduate School of Health Science, Chosun University) ;
  • Lee, San-Hui (Department of Public Health, Graduate School of Health Science, Chosun University) ;
  • Lee, Yun-Kyung (Department of Public Health, Graduate School of Health Science, Chosun University) ;
  • Ryu, So-Yeon (Department of Preventive Medicine, Chosun University Medical School)
  • 주미현 (조선대학교 대학원 보건학과) ;
  • 이산휘 (조선대학교 대학원 보건학과) ;
  • 이윤경 (조선대학교 대학원 보건학과) ;
  • 류소연 (조선대학교 의과대학 예방의학교실)
  • Received : 2018.02.21
  • Accepted : 2018.05.04
  • Published : 2018.05.31

Abstract

The aim of this study was to investigate vitamin D status and factors associated with vitamin D deficiency among Koreans in their using Korean National Health and Nutrition Examination Survey (KNHANES) V. The subjects were 1,837 people who were 20-29 years old. The data were analyzed by ${\chi}^2$ test and multiple logistic regression analysis using weighted composite sample analysis. Vitamin D deficiency was reveled in 84.2% of subjects; 88.6% of women and 79.4% of men showed deficiency. In the multiple logistic regression analysis, the risk for vitamin D deficiency was higher in women (OR 1.84; 95% CI 1.31-2.56), non-married (OR 2.12; 95% CI 1.41-3.19), poor subjective health status (OR 1.94; 95% CI 1.16-3.25), and in the absence of moderate to vigorous physical activity (OR 3.38; 95% CI 1.85-6.16). Continued research on vitamin D levels at this time is needed since vitamin D deficiency among Koreans in their twenties will exacerbate health problems, both individually and socially. In addition, vitamin D has been shown to be closely related to time of exposure to sunlight and physical activity. Therefore, it is thought that long-term and planned efforts should be made at the national level, such as establishing schools and workplaces in which those in their twenties can perform outdoor activities and moderate to vigorous physical activity.

본 연구의 목적은 '국민건강영양조사 제 5기(2010-2012)' 자료를 이용하여 만 20-29세 연령의 한국인에서의 비타민 D 수준과 비타민 D 결핍관련요인을 알아보고자 하였다. '국민건강영양조사 제 5기(2010년-2012년) 완료자중에서 비타민 D 결측치가 없는 만 20세 이상 만 29세 미만 1,837명을 대상으로 분석하였다. 사용된 데이터는 가중치가 적용된 복합표본분석을 이용하여 카이제곱검정 및 다중로지스틱 회귀분석으로 분석하였다. 20대의 84.2%가 비타민 D 결핍으로 조사되었으며 여성이 88.6%로 남성 79.4%보다 높은 결핍률을 보였다. 다중 로지스틱 회귀분석 결과, 비타민 D 결핍에 대한 위험도가 여성인 경우(OR 1.84; 95% CI 1.31-2.56), 미혼인 경우(OR 2.12; 95% CI 1.41-3.19), 주관적 건강상태가 나쁨인 경우(OR 1.94; 95% CI 1.16-3.25) 그리고 중등도 이상 신체활동을 하지 않는 경우(OR 3.38; 95% CI 1.85-6.16)에 높았다. 불확실한 미래를 위해 다양한 노력과 활동을 하는 20대의 비타민 D 결핍은 개인적으로나 사회적으로 매우 중요한 건강문제로 영향을 주기 때문에 이 시기의 비타민 D 수준에 대한 지속적인 연구가 필요할 것이다. 또한 비타민 D는 햇빛에 노출되는 시간과 신체활동 여부와 밀접한 관련이 있는 것으로 나타나 20대의 야외활동 및 중등도 이상의 신체활동을 할 수 있는 학교 및 직장 내 기반시설을 조성하는 등 국가차원에서의 장기적이고 계획적인 노력이 필요하리라고 생각된다.

Keywords

References

  1. Holick MF, "Cancer, sunlight and vitamin D", J Clin Transl Endocrinol, vol. 1, no. 4, pp. 179-186, 2014. DOI: https://doi.org/10.1016/j.jcte.2014.10.001
  2. HA Park, SY Kim, "Recent advance on vitamin D" JKMA, vol. 56, no. 4, pp. 310-318, 2013.
  3. EH Nah, SY Kim, HI Cho, "Vitamin D levels and prevalence of vitamin D deficiency associated with sex, age, region, and season in Koreans," Lab Med Online, vol. 5, no. 2, pp. 84-91, 2015. DOI: https://doi.org/10.3343/lmo.2015.5.2.84
  4. Granlund L, Ramnemark A, Andersson C, Lindkvist M, Fharm E, Norberg M, "Prevalence of vitamin D deficiency and its association with nutrition, travelling and clothing habits in an immigrant population in Northern Sweden", European Journal of Clinical Nutrition, vol. 70, no. 3, pp. 373-379, 2016. DOI: https://doi.org/10.1038/ejcn.2015.176
  5. Hoseinzadeh E, Taha P, Wei C, Godini H, Ashraf GM, Taghavi M, Miri M, "The impact of air pollutants, UV exposure and geographic location on vitamin D deficiency", Food and Chemical Toxicology, vol. 113, no. 3, pp. 241-254, 2018. DOI: https://doi.org/10.1016/j.fct.2018.01.052
  6. JH Lee, JH O'Keefe, D Bell, DD Hensrud, MF Holick, "Vitamin D deficiency: an important, common, and easily treatable cardiovascular risk factor?", J Am Coll Cardiol. vol. 52, no. 24, pp. 1949-1956, 2008. DOI: https://doi.org/10.1016/j.jacc.2008.08.050
  7. KY Ahn, JH Min, JY Jeon, "Association between Physical Activity and Vitamin D in Korean Adults Korean National Health and Nutrition Examination Survey 2009-2013," J Korean Soc. Living Environ, vol. 22, no. 5, pp. 712-721, 2015. DOI: https://doi.org/10.21086/ksles.2015.10.22.5.712
  8. EY Choi, "25 (OH) D status and demographic and lifestyle determinants of 25 (OH) D among Korean adults," Asia Pac J Clin Nutr, vol. 21, no. 4, pp. 526-535, 2012.
  9. Scragg R, Camargo CA Jr, "Frequency of leisure-time physical activity and serum 25-hydroxyvitamin D levels in the US population: results from the Third National Health and Nutrition Examination Survey," Am J Epidemiol, vol. 168, no. 6, pp. 577-586, 2008. DOI: https://doi.org/10.1093/aje/kwn163
  10. Watanabe R, Inoue D, "Update on recent progress in vitamin D research. Vitamin D insufficiency/deficiency", Clin Calcium, vol. 27, no. 11, pp. 1601-16081, 2017.
  11. Naghshtabrizi B, Borzouei S, Bigvand P, Seifrabiei MA., "Evaluation of the Relationship between Serum 25-Hydroxy Vitamin D and Hypertension in Hamadan, Iran-A Case Control Study", J Clin Diagn Res, vol. 11, no. 7, pp. LC01-LC03, 2017.
  12. Paul Lips, Marelise Eekhoff, Natasja van Schoor, Mirjam Oosterwerff, Renate de Jongh, Yvonne Krul-Poel, Suat Simsek,,"Vitamin D and type 2 diabetes", J Steroid Biochem Mol Biol, vol. 173, no. 10, pp. 280-285, 2017. DOI: https://doi.org/10.1016/j.jsbmb.2016.11.021
  13. Leu Agelii M, Lehtinen-Jacks S, Zetterberg H, Sundh V, Björkelund C, Lissner L, "Low vitamin D status in relation to cardiovascular disease and mortality in Swedish women - Effect of extended follow-up.", Nutr Metab Cardiovasc Dis, vol. 27, no. 12, pp. 1143-1151, 2017. DOI: https://doi.org/10.1016/j.numecd.2017.10.013
  14. Gandini S, Boniol M, Haukka J. Byrnes G, Cox B, Sneyd MJ, Mullie P, Autier P, "Meta-analysis of observational studies of serum 25 hydro xyvitamin D levels and colorectal, breast and prostate cancer and colorectal adenoma", Int J Cancer, vol. 128, no. 6, pp. 1414-1424, 2011. DOI: https://doi.org/10.1002/ijc.25439
  15. Holick MF, "Vitamin D deficiency", N Engl J Med, vol. 357, no. 3, pp. 266-281, 2007. DOI: https://doi.org/10.1056/NEJMra070553
  16. Forrest KY1, Stuhldreher WL, Stuhldreher, "Prevalence and correlates of vitamin D deficiency in US adults", Nutr Res, vol. 31, no. 1, pp. 48-54, 2011. DOI: https://doi.org/10.1016/j.nutres.2010.12.001
  17. Ministry of Health and Welfare. Korean health statistics 2015: Korea National Health and Nutrition Examination Survey, VI(KNHANES), 2014.
  18. HS Choi, HJ Oh, H Choi, WH Choi, JG Kim, KM Kim, KJ Kim, Y Rhee, SK Lim, "Vitamin D insufficiency in Korea-a greater threat to younger generation: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008," JCEM, vol. 96, no. 3, pp. 643-651, 2011. DOI: https://doi.org/10.1210/jc.2010-2133
  19. HR Jeong, SJ Hong, YJ Heo, HS Chun, DS Kim, JT Park, MY Kang, "Vitamin D status and associated occupational factors in Korean wage workers: data from the 5th Korea national health and nutrition examination survey (KNHANES 2010-2012)", Annals of occupational and environmental medicine, vol. 26, no. 9, pp. 22-31, 2014. DOI: https://doi.org/10.1186/s40557-014-0028-x
  20. Langlois K, Greene-Finestone L, Little J, Hidiroglou N, Whiting S, "Vitamin D status of Canadians as measured in the 2007 to 2009 Canadian Health Measures Survey," Health Rep, vol. 21, no. 1, pp. 47-55, 2010.
  21. JN Lee, IS Lee, "Comparison of Characteristics between Success Group and Failure Group of 1-year Continuous Smoking Abstinence in Young Adult and Middle-aged Male Workers: with Focus on the First-year Analysis of Korean Cross-sectional Survey," J Korean Acad Community Health Nurs, vol. 27, no. 2, pp. 95-105, 2016. DOI: https://doi.org/10.12799/jkachn.2016.27.2.95
  22. HN Yoo, HS Kim, "Vitamin D deficiency and Metabolic Syndrome among Korean Adolescents: Based on Korea National Health and Nutrition Examination Survey V (KNHANES)," J Korean Soc Health, vol. 29, no. 1, pp. 22-32, 2016. DOI: https://doi.org/10.15434/kssh.2016.29.1.22
  23. HW Byeon, "The relationship between BMI, weight perception and depression-like symptoms in Korean middle school students", Journal of the Korea Academia-Industrial cooperation Society, vol. 14, no. 12, pp. 6317-6323, 2013. DOI: http://doi.org/10.5762/KAIS.2013.14.12.6317
  24. MJ Cho, HK Kim, NR Oh, "Influence of the number of remaining teeth of on sleep time and stress of adults older than 40 years", Journal of Digital Convergence, vol. 4, no. 7, pp. 225-232, 2016. DOI: https://doi.org/10.14400/JDC.2016.14.7.225
  25. Guide to the utilization of the data from the 5th Korea National Health and Nutrition Examination Survey(2010-2012), Korea Centers for Disease Control and Prevention, pp. 277, 2012.
  26. JY Park, YR Heo, "Relationship of vitamin D status and obesity index in Korean women" J Nutr Health, vol. 49, no. 1, pp. 28-35, 2016. DOI: https://doi.org/10.4163/jnh.2016.49.1.28
  27. SK Cho, S Koo, K Park, "Vitamin D and depression" J Korean Soc Food Sci Nutr, vol. 43, no. 10, pp. 1467-1476, 2014. DOI: https://doi.org/10.3746/jkfn.2014.43.10.1467
  28. Hilger J, Friedel A, Herr R, Rausch T, et al, "A systematic review of vitamin D status in populations worldwide", Br J Nutr, vol. 111, no. 1, pp. 23-45, 2014. DOI: https://doi.org/10.1017/S0007114513001840
  29. YY Jin, HS Kang, "The Relationship between Serum Vitamin D Levels and Lifestyle Risk Factors in Office Workers" The Korean Journal of Physical Education, vol. 54, no. 5, pp. 727-737, 2015. DOI: http://doi.org/G704-000541.2015.54.5.010
  30. Zuberi LM, Habib A, Haque N, Jabbar A, "Vitamin D deficiency in ambulatory patients," J Pak Med Assoc, vol. 58, no. 9, pp. 482-484, 2008.
  31. JM Sim, HG Jeon, KC Lee, "Comparative Analysis of the Effect of Physical Activity and Stress Experience on the Vitamin D Deficiency according to Occupations: results from KNHANES dataset for 2008-2013," Journal of the Korea Contents Association, vol. 15, no. 8, pp. 505-518, 2015. DOI: https://doi.org/10.5392/JKCA.2015.15.08.505
  32. Holick MF, "Resurrection of vitamin D deficiency and rickets" J Clin Invest, vol. 116, no. 8, pp. 2062-2072, 2006. DOI: https://doi.org/10.1172/JCI29449
  33. MG Oh, MA Han, J Park, SY Ryu, SW Choi, "The prevalence of vitamin D deficiency among cancer survivors in a nationwide survey of the Korean population," PLoS One, vol. 10, no. 6, pp. e0129901, 2015. DOI: https://doi.org/10.1371/journal.pone.0129901
  34. AN Lee, SH Kim, CM Nam, YJ Kim, SH Joo, KR Lee, "Prevalence of Vitamin D Deficiency and Insufficiency in Korean Children and Adolescents and Associated Factors," Lab Med Online, vol. 6, no. 2, pp. 70-78, 2016. DOI: https://doi.org/10.3343/lmo.2016.6.2.70
  35. Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, El-Hajj Fuleihan G, Josse RG, Lips P, Morales-Torres J; IOF Committee of Scientific Advisors (CSA) Nutrition Working Group, "Global vitamin D status and determinants of hypovitaminosis D," Osteoporos Int, vol. 20, no. 11, pp. 1807-1820, 2009. DOI: https://doi.org/10.1007/s00198-009-0954-6
  36. SH Park, YW Kim, CH Chae, JS Son, CW Kim, JY Kim, JH Kim, "The Relationship of serum vitamin D levels and the Framingham Risk Score among male workers in the manufacturing Sector," Korean J Occup Environ Med, vol. 24, no. 2, pp. 115-123, 2012.
  37. Kassi EN, Stavropoulos S, Kokkoris P, Galanos A, Moutsatsou P, Dimas C, Papatheodorou A, Zafeiris C, Lyritis G., "Smoking is a significant determinant of low serum vitamin D in young and middle-aged healthy males", Hormones, vol. 14, no. 2, pp. 241-250, 2015.
  38. Jiang CQ, Chan YH, Xu L, Jin YL, Zhu T, Zhang WS, Cheng KK, Lam TH, "Smoking and serum vitamin D in older Chinese people: cross-sectional analysis based on the Guangzhou Biobank Cohort Study," BMJ Open, vol. 6, no. 6, pp. 10-19, 2016. DOI: https://doi.org/10.1136/bmjopen-2015-010946
  39. Sebekova K, Krivosikova Z, Gajdos M, Podracka L, "Vitamin D status in apparently healthy medication-free Slovaks: Association to blood pressure, body mass index, self-reported smoking status and physical activity," Bratisl Lek Listy, vol. 117, no. 12, pp. 702-709, 2016.
  40. HJ Yim, HA Park, JH Kang, KW Kim, YG Cho, YI Hur EJ Sung, "Marital status and health behaviors in middle-aged Korean adults: from the 2007-2010 Korea National Health and Nutrition Examination Survey" Korean J Health Promo, vol. 12 no. 4, pp. 178-186, 2012.
  41. Santos A, Amaral TF, Guerra RS, Sousa AS, Alvares L, Moreira P, Padrao P, Afonso C, Borges N., "Vitamin D status and associated factors among Portuguese older adults: results from the Nutrition UP 65 cross-sectional study", BMJ Open, vol. 7, no. 6, pp. 16-23, 2001.
  42. von Berens A, Cederholm T, Fielding RA, Gustafsson T, Kirn D, Laussen J, Nydahl M, Travison TG, Reid K, Koochek A., "Physical Performance and Serum 25(OH)vitamin D Status in Community Dwelling Old Mobility Limited Adults: A Cross-Sectional Study", J Nutr Health Aqing, vol. 22, no. 1, pp. 1-7, 2018. DOI: https://doi.org/10.1007/s12603-016-0849-0
  43. Ortega FB, Brown WJ, Lee DC, Baruth M, Sui X, Blair SN., "In fitness and health? A prospective study of changes in marital status and fitness in men and women", Am J Epidemiol, vol. 173, no. 3, pp. 337-344, 2010. DOI: https://doi.org/10.1093/aje/kwq362
  44. JS Yoo, JE Lim, SW Cho, HR Shin, SW Park, "The relationship between health of the elderly and medical costs - The mediating effect of exercise and self-rated health" Korean Journal of Sociology of Sport, Vol. 30, No. 3, pp. 1-18, 2017.
  45. HJ Lim, "Serum 25-hydroxyvitamin D status and associated factors in premenopausal working women", Korean J Community Nutrition, vol. 10, no. 1, pp. 79-90, 2005.
  46. IK. Jung, "Prevalence of vitamin D deficiency in Korea: Results from KNHANES 2010 to 2011", J Nutr Health, vol. 46, no. 6, pp. 540-551, 2013. DOI: https://doi.org/10.4163/jnh.2013.46.6.540