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The association between area-level demographic and socioeconomic parameters and vitamin D status in Ireland

Published online by Cambridge University Press:  30 August 2022

D. Johnston
Affiliation:
School of Biological and Health Sciences, TU Dublin, Dublin, Ireland
F. Byrne
Affiliation:
School of Biological and Health Sciences, TU Dublin, Dublin, Ireland
H. Scully
Affiliation:
Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
E. Laird
Affiliation:
Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
P. Bellew
Affiliation:
Health Intelligence Unit, HSE, Dublin, Ireland
L. Hendrick
Affiliation:
Health Intelligence Unit, HSE, Dublin, Ireland
H. Johnson
Affiliation:
Health Intelligence Unit, HSE, Dublin, Ireland
D. Byrne
Affiliation:
Department of Medical Gerontology, Trinity College Dublin, Ireland, Medicine Directorate, St James's Hospital, Dublin, Ireland
J. B. Walsh
Affiliation:
Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland Department of Medical Gerontology, Trinity College Dublin, Ireland,
M. Healy
Affiliation:
Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
V. Crowley
Affiliation:
Department of Clinical Biochemistry, St James's Hospital, Dublin, Ireland.
D. McCartney
Affiliation:
School of Biological and Health Sciences, TU Dublin, Dublin, Ireland
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Abstract

Type
Abstract
Copyright
Copyright © The Authors 2022

There is an emergent association between vitamin D deficiency (VDD) and the risk of SARS-CoV-2 infection. The prevalence of VDD in Ireland is high,(Reference Scully1)(Reference Griffin2)(Reference Laird3) particularly in older institutionalised adults(Reference Laird4) and low SES groups(Reference Griffin2) as a consequence of suboptimal sun exposure, inadequate dietary intake, unfavourable lifestyle habits, and low supplementation rates; these same groups are at higher risk of SARS-CoV-2 infection.(Reference Madden5) This research project aimed to establish a method for area-level prediction of VDD to aid in the identification of spatial areas at higher risk of VDD which might also be more vulnerable to SARS-CoV-2 infection. This study was a retrospective cross-sectional analysis of area-level vitamin D status amongst community-dwelling adults in Ireland. Serum 25(OH)D concentrations from 7,708 GP-ordered patient samples from counties Dublin, Meath, Wicklow, and North Kildare were derived from the electronic patient database at St James's Hospital, Dublin. These samples were geo-coded by the electoral division (ED) of the residential address using the Health Atlas Ireland/GeoDirectory application. The demographic profile (ethnic mix) and socioeconomic status (the relative Pobal Haase-Pratschke affluence/deprivation score) at the ED level was based on the Census 2016 Small Area Population Statistics (SAPS) published by the Central Statistics Office. The associations between the demographic and socioeconomic parameters and the mean and median ED-level 25(OH)D were examined by univariate (one-way ANOVA with Tukey's post hoc multiple comparison test, Kruskal-Wallis with Dunn's post hoc multiple comparison test) and multivariate (linear regression, multinomial logistic regression) analyses. There were 412 EDs with indicative 25(OH)D measures. VDD at area-level was defined as mild if the mean ED-level 25(OH)D was 50 - 74 nmol/L, moderate if the mean ED-level 25(OH)D was 30 - 49 nmol/L, or severe if the mean ED-level 25(OH)D was less than 30 nmol/L. ED-level socioeconomic disadvantage was associated with a higher risk of mild, moderate, and severe VDD (OR 1.042 for mild VDD, p = 0.004; OR 1.059 for moderate VDD, p = 0.003; OR 1.060 for severe VDD, p = 0.071 with each one-unit reduction in relative deprivation index score). Each percentage point increment in the prevalence of Asian and Asian Irish ethnicity at ED-level was associated with a higher risk of mild VDD (OR 1.120, p = 0.041). Low socioeconomic status and the prevalence of non-white ethnicity at ED-level are predictive of VDD in community-dwelling Irish adults. These findings support the use of area-level population statistics to predict VDD at area-level.

References

Scully, H, et al. (2020) Nutrients 12, 2663CrossRefGoogle Scholar
Griffin, TP, et al. (2020) J Gerontol A 75, 24182425CrossRefGoogle Scholar
Laird, E, et al. (2020) Nutrients 12, 3674CrossRefGoogle Scholar
Laird, E, et al. (2018) J Gerontol A 73, 519525CrossRefGoogle Scholar
Madden, JM, et al. (2021) Int J Environ Res Public Health 18, 6285CrossRefGoogle Scholar