The Epidemic and Health Risks of Vitamin-D Deficiency in Erbil

Authors: Hannah K. Surji1 & Sundes Sultan2
1Department of Biology, Faculty of Education, Tishk International University, Erbil, Iraq
2Department of Biology, Faculty of Education, Tishk International University, Erbil, Iraq

Abstract: Vitamin D, the sunshine vitamin, is any of the various vitamins that are fat-soluble, chemically related to steroids, and naturally found in very few food products. In the skin, it is produced endogenously through the exposure to sunlight (ultraviolet rays), which triggers vitamin D synthesis. Vitamin D deficiency can cause major health risks as it is linked to diabetes, cardiovascular disease, hypertension, rickets, and osteoporosis. The aims of this study are: 1- to determine the vitamin D levels of individuals (n=275) of different genders and ages who were examined in various laboratories and hospitals in Erbil. 2- To evaluate the relation between gender and age with vitamin D deficiency. 3- To determine if vitamin D deficiency is becoming an epidemic in Erbil. 4- To evaluate the major risk factors of this nutritional deficiency. In this project, vitamin D test results were collected from five different laboratories and hospitals in Erbil city, Iraq. A total of 275 samples were collected, including 166 females and 109 males of different ages ranging from 19 years or younger to 60 years or older. The results were divided based on demographic information, including age and gender. The population was further categorized according to the vitamin D levels, which consisted of deficient (0 – 20 ng/mL), insufficient (21 – 29 ng/mL), and sufficient (30 – 100 ng/mL). The results have shown that 86% of the female group was below the optimal vitamin D levels, while 82% of the males showed low levels. The results showed that there was no effect of gender and age on vitamin D levels. There was a high percentage of vitamin D deficiency in males and females in Erbil city; therefore, this research suggests that long-term vitamin D supplementation, adequate exposure to sunlight, and a balanced diet rich with enough dosage of vitamin D reduces the risk of multiple health issues.

Keywords: Epidemic, Vitamin D, Deficiency, Health Risks, Erbil

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Doi: 10.23918/eajse.v7i2p163

Published: January 30, 2022


Abdullah, S.A., Abdulrahman, R.M., Omer, K.A. (2018). Vitamin D level study within the population in Sulaymaniyah City – IRAQ. International Conference on Pure and Applied Sciences. 32-35.

Abdulrahman, R. M., & Rahman, B. M. A. (2018). Prevalence of Vitamin D level in the serum of patients living in Erbil city of Iraq that has been referred to private clinical laboratory and effect of age and sex on it. Journal of Biological Research-Bollettino della Società Italiana di Biologia Sperimentale, 91(1).

Al-Daghri, N. M. (2018). Vitamin D in Saudi Arabia: prevalence, distribution and disease associations. The Journal of Steroid Biochemistry and Molecular Biology, 175, 102-107.

Bikle, D., Adams, J., & Christakos, S. (2009). Vitamin D: production, metabolism, mechanism of action, and clinical requirements. Primer on the metabolic bone diseases and disorders of mineral metabolism, 7.

Bikle, D. D. (2014). Vitamin D metabolism, mechanism of action, and clinical applications. Chemistry & Biology, 21(3), 319-329.

Dini, C., & Bianchi, A. (2012). The potential role of vitamin D for prevention and treatment of tuberculosis and infectious diseases. Annali Dell’istituto Superiore Di Sanita, 48, 319-327.

Flood-Nichols, S. K., Tinnemore, D., Huang, R. R., Napolitano, P. G., & Ippolito, D. L. (2015). Vitamin D deficiency in early pregnancy. PLoS One, 10(4), e0123763.

Gil, Á., Plaza-Diaz, J., & Mesa, M. D. (2018). Vitamin D: Classic and novel actions. Annals of Nutrition and Metabolism, 72(2), 87-95.

Grant, W. B., & Holick, M. F. (2005). Benefits and requirements of vitamin D for optimal health: A review. Altern Med Rev, 10(2), 94-111.

Hamza, R. T., Awwad, K. S., Ali, M. K., & Hamed, A. I. (2011). Reduced serum concentrations of 25-hydroxy vitamin D in Egyptian patients with systemic lupus erythematosus: Relation to disease activity. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 17(12), 711-718.

Hess, A. F. (1922). The prevention and cure of rickets by sunlight. American Journal of Public Health, 12(2), 104-107.

Holick, M. F., Binkley, N. C., Bischoff-Ferrari, H. A., Gordon, C. M., Hanley, D. A., Heaney, R. P., … & Weaver, C. M. (2011). Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 96(7), 1911-1930.

Holick, M. F., & Chen, T. C. (2008). Vitamin D deficiency: a worldwide problem with health consequences. The American Journal of Clinical Nutrition, 87(4), 1080S-1086S.

Holick, M. F. (2010). The vitamin D deficiency pandemic: A forgotten hormone important for health. Public Health Reviews, 32(1), 267-283.

Holick, M. F. (2005). The Vitamin D Epidemic and its Health Consequences. The Journal of Nutrition, 135(11), 2739-2748.

Holick, M. F. (2007). Vitamin D deficiency. New England Journal of Medicine, 357(3), 266-281.

Hossein-nezhad, A., & Holick, M. F. (2013). Vitamin D for health: A global perspective. In Mayo clinic proceedings. Elsevier, 88(7), 720-755.

Khazaei, Z., Khazaei, S., Beigrezaei, S., & Nasri, H. (2018). Vitamin D deficiency in healthy people and its relationship with gender and age. Journal of Parathyroid Disease, 6 (1), 17.

Lappe, J. M., Travers-Gustafson, D., Davies, K. M., Recker, R. R., & Heaney, R. P. (2007). Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. The American journal of Clinical Nutrition, 85(6), 1586-1591.

Lee, J. H., O’Keefe, J. H., Bell, D., Hensrud, D. D., & Holick, M. F. (2008). Vitamin D deficiency: an important, common, and easily treatable cardiovascular risk factor?. Journal of the American College of Cardiology, 52(24), 1949-1956.

Lhamo, Y., Chugh, P. K., Gautam, S. R., & Tripathi, C. D. (2017). Epidemic of Vitamin D Deficiency and Its Management: Awareness among Indian Medical Undergraduates. Journal of Environmental and Public Health, 2017, 1-7.

Lips, P., Hosking, D., Lippuner, K., Norquist, J. M., Wehren, L., Maalouf, G., … & Chandler, J. (2006). The prevalence of vitamin D inadequacy amongst women with osteoporosis: an international epidemiological investigation. Journal of Internal Medicine, 260(3), 245-254.

Liu, Z. M., Woo, J., Wu, S. H., & Ho, S. C. (2013). The role of vitamin D in blood pressure, endothelial and renal function in postmenopausal women. Nutrients, 5(7), 2590-2610.

Micozzi, M. S., & Maryland, B. (2008). Confronting the Worldwide Epidemic of Vitamin D Deficiency. Nutri News. 9(3), 1-8.

Mithal, A., Wahl, D. A., Bonjour, J.-P., Burckhardt, P., Dawson-Hughes, B., Eisman, J. A., … Morales-Torres, J. (2009). Global vitamin D status and determinants of hypovitaminosis D. Osteoporosis International, 20(11), 1807–1820.

Nasri, H. (2017). The adverse effects of vitamin D deficiency on health. Journal of Renal Endocrinology, 3(1), e03-e03.
Parva, N. R., Tadepalli, S., Singh, P., Qian, A., Joshi, R., Kandala, H., … Cheriyath, P. (2018). Prevalence of Vitamin D Deficiency and Associated Risk Factors in the US Population (2011-2012). Cureus, 10(6), e2741.

Ross, A. C., Taylor, C. L., Yaktine, A. L., & Valle, H. B. (2011). Dietary reference intakes for calcium and Vitamin D. Washington: National Academies Press.

Rostand, S. G. (1997). Ultraviolet light may contribute to geographic and racial blood pressure differences. Hypertension, 30(2), 150-156.

Shaw, N. J. (2003). Vitamin D deficiency rickets. Endocrine Development, 6, 93-104.

Silva, P. Z. da, & Schneider, R. H. (2016). The Role of Vitamin D in Muscle Strength among the Elderly. Acta Fisiátrica, 23(2), 96–101.

Steenbock, H. (1924). The induction of growth promoting and calcifying properties in a ration by exposure to light. Science, 60(1549), 224-225.

Van Der Rhee, H., Coebergh, J. W., & de Vries, E. (2009). Sunlight, Vitamin D and the Prevention of Cancer: a Systematic Review of Epidemiological Studies. European Journal of Cancer Prevention, 18(6), 458–475.
Vitamin D. (n.d.). Retrieved from D

Wagner, C. L., & Greer, F. R. (2008). Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents. Pediatrics, 122(5), 1142-1152.

Wang, H., Chen, W., Li, D., Yin, X., Zhang, X., Olsen, N., & Zheng, S. G. (2017). Vitamin D and Chronic Diseases. Aging and Disease, 8(3), 346-353.

Zangana, S. N., Mahmood, M. S., & Ismael, S. A. (2016). 25-Hydroxyvitamin D and parathyroid hormone levels and their associations with left ventricular hypertrophy in a sample of hypertensive patients in Erbil-Iraq. Int J Acad Res Dev, 1, 32-6.