Socioeconomic and environmental determinants and hypovitaminosis D in adolescents in the northeast of Brazil: a hierarchical approach

Authors

DOI:

https://doi.org/10.33448/rsd-v11i8.30496

Keywords:

Hypovitaminosis D; Socioeconomic factors; Hierarchical approach; Adolescents; Brazil.

Abstract

Family socioeconomic and environmental conditions are associated with health status and disease outcomes in infancy, acting at different levels of determination over these events, positively or negatively affecting individuals. Methods was adopted a hierarchical approach to investigate a vitamin D insufficiency and socioecomimc determinants in the basic, intermediate, and immediate levels. The logistic regression and odds ratio (OR) as an association measure were used to assess the relationship of interest. The prevalence of vitamin D insufficiency (10-29.9 ng/ml) was 54.1% of the adolescents, no vitamin D deficiency (<10 ng/ml) was identified. At the basic level, was observed a 52% protective effect (OR = 0.48; p< 0.003) of the low socioeconomic stratum for the occurrence of insufficient vitamin D levels; living in rural area increased by 2.35 times more chances of having insufficient vitamin D levels (OR = 2.35; p < 0.001). At the intermediate level, the sanitary conditions of the household situated at the lowest level of the distribution tercile, resulted in a 1.41% higher risk (OR = 2.41; p < 0.034) of those conditions being associated with vitamin D insufficiency. At the immediate level, the results showed that those with 14-years had 2.37 times more chances (OR = 2.37; p < 0.024) and to be black/brown skin (OR = 2.00; p < 0.047) were associated with vitamin D insufficiency. Conclusion socioeconomics factors and individual level were associated with vitamin D insufficiency in adolescents.

References

Al-Agha, A.E, Alsharief, A.A, Ahmed, M.S., & Nassir, A.Y (2016) The Effect of Socioeconomic Status on Vitamin D Level in Children’s and Adolescents Living at Jeddah, Saudi Arabia. Evid Based Med Pract 2: 109. 10.4172/2471-9199.1000109

Assis, A.M.O, Barreto, M.L, Santos, N.S, & Oliveira, L. P. M. (2007) et al Desigualdade, pobreza e condições de saúde e nutrição na infância no Nordeste brasileiro Cad. Saúde Pública, Rio de Janeiro, 23(10):2337-2350pp

Brasil (2017) Sociedade Brasileira de Patologia Clínica e Medicina Laboratorial.

Brasil. (2019)IBGE-Instituto Brasileiro de Geografia e Estatistica (2019)

Brasil (2019)https://cidades.ibge.gov.br/brasil/ba/mutuipe/panorama

Brasil(2019)https://cidades.ibge.gov.br/brasil/ba/laje/panorama

CDC (Control Disease Center) Growth Charts for the United States (2002) Methods

and Development, series 11, number 246, 2002, 203 pp.

Clemens, T.L, Adams, J.S, Nolan, J.M & Holick, M. F (1982) Measurement of circulating vitamin D in man Clinica Chimical Acta, 121 301-308pp.

Ohlund, I. S, Hernell S.A, & LIND, T Serum 25-Hydroxyvitamin D Levels in Preschool-Age Children in Northern Sweden Are Inadequate After Summer and Diminish Further During Winter JPGN 2013,56: 551–555

Daniel, J.B, Elisabete, P, Queiroz, V.O & Oliveira, A.M (2019) The Anthropometric Deficits in Children Under Five Years old in Tete Province Mozambique Using Hierarchy Approach OJEPI. 9(1)

Delvin, E.E, Lambert, M, Levy, E, O’loughlin, & Mark, J (2010) Vitamin D Status Is Modestly Associated with Glycemia and Indicators of Lipid Metabolism in French-Canadian Children and Adolescents, J. Nutr. 140: 987–99.

De Onis, M, Onyango, A.W, Borghi, E & Siyam, A et al (2007) Development of WHO growth reference for School aged Children and Adolescents bulletin of the World Health Organization, 85: 660- 667pp.

Diasorin, Lialson 25 (OH) D vitamin D total assay (2019) Referencia 310600 PT- 52362, 11pp.

Fang, P, Dong, S, Xiao, J, Liu, C, & Feng, X, et al (2010) Regional inequality in health and its determinants: Evidence from China Health Policy 94 14–25

Fonseca, N.S.N (2012) Efeito da Suplementação Materna com Vitamina A no puerpério sobre o Estado de Saúde e Nutrição em Crianças: um Estudo de Coorte, 125.

Gu, Y, Zhang, H, Ali, S.H, HUANG, M, WEI, J, & GU, S (2019) Social Determinants of Health-Related Quality of Life among Residents in Zhejiang and Qinghai, China. Int. J. Environ. Res. Public Health, 16, 1314, 10.3390/ijerph16081314

Hintzpeter, B, Scheidt.N.C, Müller, M.J & Schenk, L (2008) Higher Prevalence of Vitamin D Deficiency Is Associated with Immigrant Background among Children and Adolescents in Germany The Journal of Nutrition J. Nutritional Epidemiology-1482-90pp.

Holick, F.M The Vitamin D deficiency pandemic (2017) Approaches for diagnosis, treatment and prevention, Rev Endocr Metab Disord 18:153–165ppDOI 10.1007/s11154-017-9424-1.

Holick, F.M vitamin D deficiency (2007) N Engl J Med,357:266-81.

Hosmer, D. W & Lemeshow, S (2000) Applied logistic regression, second edition printed in USA, 2000, 375

Isller, R.M.S & Giugliani E.R.J. (1997) Identificação de grupos mais vulneráveis à desnutrição infantil pela medição do nível de pobreza. J Pediatr (Rio de J), 73:101-5.

Kapil, U, Pandey, R.M, Goswami, R & Sharma, B (2017) Prevalence of Vitamin D deficiency and associated risk factors among children residing at high altitude in Shimla district, Himachal Pradesh, India. Indian J Endocr Metab, 21:178-83pp.

Kim, J-S (2019) Factors Associated with Vitamin D Status Among Korean Female Adolescents Journal of Pediatric Nursing 44 -79–83.

Linhares, E.R, Jones, D.A, Round, J.M & Edwards R.H.T (1984) Effect of nutrition on vitamin D status: studies on healthy and poorly nourished Brazilian children. American Journal of clinical Nutrition 39: 125-130pp.

Lohman, T.G, Roche, A.F & Martorell, R. (1988) Anthropometric standardization reference manual. Human Kinetics Books, Illinois, USA, 124p

Martins, A.P.B, Monteiro, C.A (2016) Impact of the Bolsa Família program on food availability of low-income Brazilian families: a quasi-experimental study BMC Public Health 16:827 DOI 10.1186/s12889-016-3486-y

Marwaha, R.K, Tandon, N, Reddy, D.R.H.K, & Aggarwal, R (2005) Vitamin D and bone mineral density status of healthy schoolchildren in northern India, Am J Clin Nutr 2005,82:477– 482.

Mechenro, J, Venugopal. G, Kumar, M.B, & Balakrishnan, D (2018) Vitamin D status in Kanchipuram District, Tamil Nadu, India, BMC Public Health 18:1345https://doi.org/10.1186/s12889-018-6244-5

Melamed, M.L, Michos, E.D, Post W & Astor, B (2008) 25-Hydroxyvitamin D Levels and the Risk of Mortality in the General Population Arch Intern Med.168(15):1629-1637pp.

Morcillo, A. J. R, Martínez, F.J M, Susarte & Montoro, C.H (2019) Social Determinants of Health, the Family, and Children’s Personal Hygiene: A Comparative Study, Int. J. Environ. Res. Public Health 16, 4713, 10.3390/ijerph16234713

Morisset, A.S, Weiler, H.A, Dubois, L, Ashley & Martin.J (2016) . Rankings of iron, vitamin D, and calcium intakes in relation to maternal characteristics of pregnant Canadian women, Appl. Physiol. Nutr. Metab. 41: 749–757 (2016)

Munns, C.F, Shaw, N, Kiely, M & Specker, B.L (2016) Global Consensus Recommendations on Prevention and Management of Nutritional Rickets J Clin Endocrinol Metab, February 2016, 101(2):394–415

Neves, J.P.R, Queiroz, D.J.M, Araújo, E.P.S, Lucena, L.L, Nascimento, R.A.F, Carvalho & Costa, A.T (2020) Variants rs1544410 and rs2228570 of the vitamin D receptor gene and glycemic levels in adolescents from Northeast Brazil. Nutr Hosp, 37(1):21-27 http://dx.doi.org/10.20960/nh.02587.

Oliveira, V.A, Assis, A.M.O, Pinheiro, S.M.C & Barreto, M.L (2006) Determinantes dos déficits ponderal e de crescimento linear de crianças menores de dois anos - Determinants of weight and linear growth deficits in children under two years of age Revista Saúde Pública 40(5):874-82.

Oliveira, R.MS, Novaes, J.F, Azeredo, L.M & Cândido, A.P.C (2013) Association of vitamin D insufficiency with adiposity and metabolic disorders in Brazilian Adolescents Public Health Nutrition: 17(4), 787–79pp

Paes-Silva, R.P, Tomiya, M.T.O, Maio R, C.M.M.B, & Arruda I.K.G (2018) Prevalence and factors associated with fat-soluble vitamin deficiency in adolescents 1699-5198 - ISSN: 0212-1611 - Coden Nuhoeq S.V.R. 31

Puri, S, Marwaha, R.K, Agarwal, N & Tandon, N (2008) Vitamin D status of apparently healthy schoolgirls from two different socioeconomic strata in Delhi: relation to nutrition and lifestyle British Journal of Nutrition 99, 876–882.

Reesukmal, K. Manonukul, K, Jirapongsananuruk, O & Krobtrakulchai, W et al (2015) Hypovitaminosis D in healthy children in Central Thailand: prevalence and risk factors BMC Public Health 15:248 DOI 10.1186/s12889-015-1588-6

Reis, J.P, Mühlen, D.V, Miller,E.R,. Michos, E.D & Appel, L.J (2009) Vitamin D Status and Cardiometabolic Risk Factors in the US Adolescent Population Pediatrics. 2009 September, 124(3).

Robl, R, Uber, M, Abbage, K.T & Lima, M.N (2016) serum vitamin D levels not associated with Atopic Dermatitis Severity Pediatric Dermatology Vol. 33 No. 3 283–288.

Rosen, C.J Vitamin D Insufficiency (2011) N Engl J Med ,364:248-54.

Saintonge, S, Bang, H & Gerber, L.M (2009) Implications of a New Definition of Vitamin D Deficiency in a Multiracial US Adolescent Population: The National Health and Nutrition Examination Survey III Pediatrics ,123:797–803.

Salamoun, M.M, Kizirian, A.S, Tannous, R.I & Nabulsi, M.M (2005) Low calcium and vitamin D intake in healthy children and adolescents and their correlates European Journal of Clinical Nutrition 59, 177–184pp.

Santos Araújo, E.P.S, Queiroz, D.J.M, NEVES, J.P.R & LACERDA, L.M (2017) Prevalence of hypovitaminosis D and associated factors in adolescent students of a capital of northeastern Brazil. Nutr Hosp, 34:1416-1423pp

Paes-Silva, R.P, Tomiya, M.T.O, Maio, R, & Castro, M.M.B (2018) Prevalence and factors associated with fat-soluble vitamin deficiency in adolescents ISSN (electrónico): 1699-5198 - ISSN (papel): 0212-1611 - coden nuhoeq S.V.R. 318

Peters, B.S.E, Verlyjr, Marchioni, D.M.L, Fisberg, M & Martini, L.A (2012) The influence of breakfast and dairy products on dietary calcium and vitamin D intake in postpubertal adolescents and young adults. Journal of Human Nutrition and Dietetics J Hum Nutr Diet, 25, 69–74pp.

Pereira-Santos, M, dos Santos, J.Y.G & Carvalho, G.Q (2018) Epidemiology of vitamin D insufficiency and deficiency in a population in a sunny

country: Geospatial meta-analysis in Brazil Critical Reviews in food science and nutrition https://doi.org/10.1080/10408398.2018.1437711

Salamoun, M.M, A.S Kizirian, A.S, Tannous, R.I, & Nabulsi, M.M (2005) Low calcium and vitamin D intake in healthy children and adolescents and their correlates European Journal of Clinical Nutrition 59, 177–184

UNICEF The State of the World’s Children (1998): A UNICEF Report Malnutrition: Causes, Consequences, and Solutions Nutrition Science Policy, 115-123.

UNICEF (1990) strategy for improved nutrition of children and women in developing countries USA, 27-38.

Victora, G.C, Huttly, S.R, Fuchs, S.C & Olinto, M.T.A (1997) The Role of conceptual Frameworks in Epidemiology Analyses A Hierarchical Approach, international Journal of Epidemiology, vol 26. N0 1 Printed in Great Britain, 224-227.

Wakayo, T, Belachew, T, Vatanparast, H & Whiting, J. (2015) Vitamin D Deficiency and Its Predictors in a Country with Thirteen Months of Sunshine: The Case of School Children in Central Ethiopia Ethiopia. PLoS ONE 10(3): e0120963. 10.1371/ journal. pone.0120963.

Wickens, T.D (1998) Categorical data analysis. Rev. Psychology. (48):537-58.

Witte, J.S, Greenland, S, Kim, L.L, & Arab, L (2000) Multilevel Modeling in Epidemiology with GLIMMIX Epidemiology 11(6), 684-688.

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Published

26/06/2022

How to Cite

DANIEL, J. B.; COSTA, P. R. de F. .; QUEIROZ, V. A. de O. .; PINTO, E. de J. .; CONCEIÇÃO, G. C. da .; ASSIS, A. M. de O. . Socioeconomic and environmental determinants and hypovitaminosis D in adolescents in the northeast of Brazil: a hierarchical approach. Research, Society and Development, [S. l.], v. 11, n. 8, p. e44811830496, 2022. DOI: 10.33448/rsd-v11i8.30496. Disponível em: https://www.rsdjournal.org/index.php/rsd/article/view/30496. Acesso em: 19 apr. 2024.

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Health Sciences