Vitamin D (Vit D) plays multiple roles in bodily functions. Vit D deficiency is a common, but often under-diagnosed condition with possible serious complications. According to some research, Vit D is important particularly among women and children. No data were found concerning the Vit D status among urban Bedouin women of childbearing age. The research study is retrospective and descriptive. We analyzed 202 medical histories of patients undergoing blood tests for Vit D level for various reasons. The main objectives of the research were: 1) determining the prevalence of the Vit D deficiency among the Bedouin women of childbearing age; 2) identifying the causes for the physicians’ reasons for suspecting Vit D deficiency: the complaints or symptoms which cause the doctor to test for Vit D level. As a result, in 80.7% of those tested for Vit D, levels were less than 10 ng/ml, and in 19.3%, levels of 10 to 20 ng/ml were found. In lieu of our findings and in order to prevent serious health problems, Vit D screening plan should be seriously considered and discussed in the Bedouin population with high risk of deficiency.
Vitamin D (Vit D) has multiple roles in human health. Vit D deficiency is a common, but often under-diagnosed condition with serious complications. Deficiency is predominantly common in the geriatric population, and has been associated with increased risk of musculoskeletal, neuropsychiatric, cardiovascular, endocrine and oncologic disease. Although the morbidity of Vit D deficiency is well known in the elderly and among children, physicians are unlikely to consider it as a diagnosis in young adults, even when it is symptomatic [
The endocrine society clinical practice guideline recommends that clinicians screen for Vit D deficiency in people at risk for deficiency, such as obese individuals, blacks, pregnant and lactating women, patients treated with certain medications (anticonvulsant, glucocorticoids, antifungals such as ketoconazole) and patients with malabsorption syndromes. There are no guidelines for screening individuals who are not at risk [
A comprehensive MEDLINE search was conducted. No data were found concerning the Vit D status among urban Bedouin women of childbearing age.
The objectives of the research:
1) Determining the prevalence of the Vitamin D deficiency among the Bedouin women of childbearing age in an urban population of one family doctor practice in Southern Israel.
2) Identifying the causes for the physicians’ reasons for testing Vit D levels in the blood, such as the complaints or symptoms causing the doctor to suspect Vit D deficiency.
3) Identifying diseases associated to Vit D deficiency in our sample, comparing them to the known data given in the literature.
The research study is retrospective and descriptive.
Urban Bedouin women who receive medical care service in one family-physician practice in the “Clalit Health Services” Clinic, in Rahat, the largest Bedouin town in Israel. This clinic serves low-income population. In the practice there are about 1800 patients, among them 652 women, childbearing ages of 20 - 50 years old. The study population included women who from 2008 up to 2011 had undergone at least one blood test for Vit D level that was measured by a diasorin 25-OH-D assay.
A report of all patients was extracted from the medical computerized information system (“Clicks”). We analyzed 202 medical histories of patients undergoing blood tests for Vit D level for various reasons (pain of extremities, general pain, headache, paresthesias, fatigue, dizziness, sleep disturbance, decrease in memory, mood fluctuations, etc.).
Data were analyzed using SPSS 17 software. Frequencies were used to describe categorical variables. Mean, standard deviation and median were used to describe continuous variables. In order to compare statistically significant differences between patients’ different vitamin D levels, Chi-square tests were performed. P < 0.05 was considered statistically significant.
Median age was 37 years old. Most of them were multipara (
In our research we found very low levels of Vit D in study population, along with different features or symp-
Mean (±sd) | Median | Range | N (%) | |
---|---|---|---|---|
Age | 36.84 ± 8.292 | 37 | 20 - 52 | 202 |
BMI | 27.47 ± 5.772 | 26.9 | 16 - 55 | 201 |
Number of springs under 18 years | 5.04 ± 3.581 | 5 | 0 - 15 | 202 |
Number of visits to the clinic in the last year | 8.78 ± 5.467 | 8 | 1 - 30 | 201 |
Skin color | ||||
White | 56 (28%) | |||
Intermediate | 127 (63%) | |||
Black | 19 (9%) | |||
Face veil | ||||
Yes | 5 (2.5%) | |||
No | 197 (97.5%) |
Complains | N | % | Missing |
---|---|---|---|
Backache, arthralgia | 100 | 49.8% | 3 |
General pain | 57 | 28.4% | 3 |
Other | 54 | 26.7% | 2 |
Dizziness | 48 | 23.8% | 2 |
Headache | 47 | 23.3% | 2 |
Fatigue | 45 | 22.3% | 2 |
Prox. weakness | 30 | 14.9% | 2 |
Insomnia | 6 | 3.0% | 2 |
Recurring falls | 2 | 1.0% | 2 |
Diseases | N | % | Missing |
---|---|---|---|
Neuro-Psych. D-S | 26 | 12.9% | 2 |
Musc.-Scel. D-S | 18 | 8.9% | 2 |
Autoimmune D-S | 12 | 6.0% | 3 |
Hypertension | 10 | 5.0% | 2 |
Diabetes mell. | 9 | 4.5% | 3 |
Malabsorption sdms | 8 | 4.0% | 2 |
Malignancy | 6 | 3.0% | 3 |
Asthma | 5 | 2.5% | 2 |
Chr. medications using | 4 | 2.0% | 2 |
Fractures | 3 | 1.5% | 3 |
toms of vitamin D deficiency in the majority of women. Any of the surveyed patients had no normal or close to normal Vit D level. When we started to elucidate the phenomenon, we understood that we have more questions than answers: How can this phenomenon be explained? How does it influence the wellbeing of the women? What is the kind of problems we should anticipate in the future?
The list of organs and body systems in which Vit D plays a functional role is constantly increased. The precise role of low Vit D in the pathogenesis of some diseases is unclear. There are many controversies in current literature whether the associations are causal or due to confounding [
We did not find an association between low Vit D and specific diseases or malignancy. Possibly this lack of association can be explained by the relatively young age of women or by the small sample size. A majority of women suffered from different kinds of pain (pain of limbs, general pain, headache, etc.). Possibly this presentation among patients with these complains might be an additional guideline for primary physicians to check levels of Vit D in high risk population such as ours. Some research’s investigated connection between fibromyalgia and Vit D, and didn’t find association between low level of vitamin D and a fibromyalgia [
In lieu of our findings and in order to prevent serious health problems, Vit D screening plan should be seriously considered and discussed among those servicing this population with high risk of deficiency. No doubt, that even very low-level Vit D deficiency can be indicative of disturbances which can be prevented or reversed by
Level of Vitamin D | P value | ||||
---|---|---|---|---|---|
10 or less (N = 163) | More than 10 (N = 39) | ||||
N | % | N | % | ||
Number of visits to the clinic in the last year | |||||
0 - 6 | 75 | 46.0% | 10 | 26.3% | 0.02 |
7+ | 88 | 54.0% | 28 | 73.7% | |
163 | 38 | ||||
BMI | |||||
Less than 27 | 78 | 47.9% | 23 | 60.5% | 0.11 |
27+ | 85 | 52.1% | 15 | 39.5% | |
163 | 38 | ||||
Number of complaints | |||||
0 - 2 | 125 | 76.7% | 30 | 78.9% | 0.476 |
3 + | 38 | 23.3% | 8 | 21.1% | |
163 | 38 | ||||
Skin color | |||||
White | 47 | 28.8% | 9 | 23.1% | 0.769 |
Intermediate | 101 | 62.0% | 26 | 66.7% | |
Black | 15 | 9.2% | 4 | 10.3% | |
163 | 39 |
early diagnosis and prompt medical treatment. More extensive research investigations should substantiate our findings.