Vitamin D status in Armenian women: a stratified cross-sectional cluster analysis

Background Vitamin D plays a critical role in skeletal development and maintenance, thus sufficiency is an important goal for public health programs. Given the absence of foods fortified in vitamin D in Armenia, we hypothesized that vitamin D insufficiency would be widespread. Methods We conducted a random modified cluster model survey of vitamin D status of women in the country. We measured 25-hydroxyvitamin D [25(OH)D] by liquid chromatography mass spectrometry in dried blood spot samples and utilized a questionnaire to assess lifestyle factors. Results In summer, we sampled 1206 participants from 40 communities in Armenia. Mean 25-OH D level among women aged 18-24 was 20 +/- 8 ng/mL; aged 25-64 was 21 +/- 7 ng/mL; and >65 was 18 +/- 8 ng/mL. The country-wide mean of the entire female population was 20 +/- 8 ng/mL. A majority (>54%) had 25-OH D levels <20 ng/mL with nearly 13% having 25-OH D levels <12 ng/mL. Participants who reported calcium, vitamin D, or multivitamin supplementation had higher levels of 25-OH D (p values 0.004, 0.0002, and 0.03 respectively) as did pre- vs. postmenopausal women (p = 0.01), pregnant vs. nonpregnant women (p = <0.0001), and women who had experienced a sunburn in the past year (p = 0.004). Conclusion In Armenia, there is a high prevalence of vitamin D insufficiency. This information provides data that can be used to inform public health directives to address this pervasive threat to optimal health.

Automated summary

In Armenia, there is a high prevalence of vitamin D insufficiency among women, with the majority having levels below the standard. Supplementation with calcium, vitamin D, or multivitamins, as well as sun exposure, were associated with higher levels of vitamin D.