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home:pathogenesis:vitamind:latitude [03.06.2011] – external edit 127.0.0.1home:pathogenesis:vitamind:latitude [10.26.2018] – [Causation – the elusive grail of epidemiology] sallieq
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   * **atherosclerosis in African Americans** – Vitamin D is widely used to treat patients with osteoporosis and/or low vitamin D levels based on a medically accepted normal range. This "normal" range is typically applied to all race groups, although it was established predominantly in whites. It is thought that as low vitamin D levels rise to the normal range with supplementation, protection from bone and heart disease (atherosclerosis) may increase, as well. Blacks generally have lower vitamin D levels than whites, partly because their darker skin pigmentation limits the amount of the vitamin produced by sunlight. "Despite" these lower vitamin D levels and dietary calcium ingestion, blacks naturally experience lower rates of osteoporosis and have far less calcium in their arteries. Studies further reveal that black patients with diabetes have half the rate of heart attack as whites, when provided equal access to health care. A 2010 study (explained [[http://www.sciencedaily.com/releases/2010/03/100315091259.htm|here]]) determined the relationship between circulating vitamin D levels and arterial calcium in 340 black men and women with type 2 diabetes.(({{pubmed>long:20061416}})) The team concluded that higher circulating levels of 25-D in blacks were associated with higher levels of calcified atherosclerotic plaque.    * **atherosclerosis in African Americans** – Vitamin D is widely used to treat patients with osteoporosis and/or low vitamin D levels based on a medically accepted normal range. This "normal" range is typically applied to all race groups, although it was established predominantly in whites. It is thought that as low vitamin D levels rise to the normal range with supplementation, protection from bone and heart disease (atherosclerosis) may increase, as well. Blacks generally have lower vitamin D levels than whites, partly because their darker skin pigmentation limits the amount of the vitamin produced by sunlight. "Despite" these lower vitamin D levels and dietary calcium ingestion, blacks naturally experience lower rates of osteoporosis and have far less calcium in their arteries. Studies further reveal that black patients with diabetes have half the rate of heart attack as whites, when provided equal access to health care. A 2010 study (explained [[http://www.sciencedaily.com/releases/2010/03/100315091259.htm|here]]) determined the relationship between circulating vitamin D levels and arterial calcium in 340 black men and women with type 2 diabetes.(({{pubmed>long:20061416}})) The team concluded that higher circulating levels of 25-D in blacks were associated with higher levels of calcified atherosclerotic plaque. 
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 +<blockquote>Serum 25(OH)D concentrations in sunny Israel.Saliba W, Rennert HS, Kershenbaum A, Rennert G
 +Osteoporos Int Mar 2011;
 +Full text via publisher | Download citation
 +Affiliation
 +Department of Community Medicine and Epidemiology, Carmel Medical Center, Clalit Health Services, and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 7 Michal St., Haifa, 34362, Israel, saliba_wa@clalit.org.il.
 +Abstract
 +This study assesses vitamin D status in Israel. Serum 25(OH)D levels <25 and <50 nmol/L are common in Israel with noted differences between Arabs and Jews, Arab females were particularly at high risk. These findings may require public health intervention at the population level. INTRODUCTION: Small studies from Israel have suggested a high prevalence of hypovitaminosis D. The objective of this study was to evaluate the extent of hypovitaminosis D among demographic subgroups in Israel. METHODS: The data of this study are from the Clalit Health Services (CHS) which is a non-for-profit health maintenance organization (HMO) covering more than half of the Israeli population. We included all CHS members for whom a 25(OH)D test result in 2009 was available and who were not taking vitamin D supplements in 2008-2009 before that 25(OH)D result. Complete data were available for 198,834 members. RESULTS: The mean level of 25(OH)D was 51.9 ± 24.5 nmol/L and was higher in summer compared to winter (P < 0.0001). Level <25, <37.5, and <50 nmol/L were detected in 14.4%, 30.7%, and 49.9% of tests; 16.4% had levels >75 nmol/L. Females had higher prevalence of 25(OH)D levels < 50 nmol/L which were found in 51.8% of females versus 45.0% in males (P < 0.0001); 76.7% of the Arabs had levels <50 nmol/L versus 46.5% in Jews (P < 0.0001). Arabs females were particularly at high risk for 25(OH)D <50 nmol/L; 84.8% of them had levels <50 nmol/L versus 48.1% of Jewish females (P < 0.0001). The relation of 25(OH)D levels with age had a sinusoidal shape among Jews, a U-shape in Arab females, and inverse linear pattern in Arab males. CONCLUSIONS: 25(OH)D levels <25 and <50 nmol/L are common in Israel. Public health measures are needed for values lesser than about 30 nmol/L and further monitoring of concentrations between about 30 and 50 nmol/L to determine if there are adverse health effects.
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 +</blockquote>
  
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