Extent of Vitamin D Deficiency in Kuwaiti Adolescent Females: Implications for Peak Bone Mass Attainment.
Bibliographic record
Abstract
There is growing evidence that females in the Middle East are not obtaining sufficient amounts of vitamin D, the perceived reason being their unhealthy lifestyle. This situation is a cause for concern particularly for adolescent females, because adequate vitamin D status has been shown to promote bone mineral accrual in adolescence. Achieving a high peak bone mass (PBM) may help decrease the risk of postmenopausal osteoporosis and fragility fractures. The aim of this study was to assess the vitamin D status among Kuwaiti adolescent girls and to assess its impact and those of lifestyle, on their bone mass. A total of 233 adolescent females (mean age 15. 4 +/- 1. 67 y) were enrolled in the study. Fasting blood samples were assayed for vitamin D status (ie, 25(OH)D), parathyroid hormone (PTH) and adjusted serum calcium. Lumbar spine-bone mineral content (LS-BMC) (L1-L4) was measured using dual-energy x-ray absorptiometry (DXA) (Hologic, QDR 4500). Anthropometric measurements and skin colour-type were determined by standard methods. Food intake was assessed by a food frequency questionnaire. Duration of sunshine exposure, mode of dress and physical activity level were also obtained in standard questionnaires. Results showed that mean +/- SD 25(OH)D was 21. 4 +/- 7. 39 nmol/L, whereas that of PTH was 9. 8 +/- 13. 54 pmol/L, and mean adjusted serum calcium was 2. 29 +/- 0. 11 mmol/L. None of the girls had an adequate vitamin D status (serum 25(OH)D <75 nmol/L), 89. 3 % had levels below 30 nmol/L and 52. 8 % had levels below 20 nmol/L. Mean +/- SD LS-BMC was 47. 5 +/- 9. 7 g. Only 33 % of the girls consumed milk or sour milk daily, whereas 45 % of the girls consumed carbonated drinks daily. Only 15 % of the total girls were engaged in physical activity. Milk intake was the only predictor of vitamin D status in both seasons (adjusted r2=0. 016, p=0. 032). Those who consumed milk less than 1 time/week had a mean +/-SD 25(OH)D of 19. 7 +/- 6. 5 nmol/L compared to those who consumed milk 1-2 times a week (21. 3 +/- 5. 5 nmol/L). Those who consumed milk more than 3 times a week had the highest level of 25(OH)D (22. 7 +/- 8. 6 nmol/L). Predictors of LS-BMC were puberty, body size and PTH {adjusted r2= 0. 555, p<0. 001). Milk intake contributed non-significantly to 1. 2 % of the variation in LS-BMC, whereas, meat intake contributed negatively to 4. 3 % of the variation (p=0. 007). Weight bearing activity contributed to 1. 5 % of the variation in LS-BMC. Those who were physically active had LS-BMC of 51. 8 +/- 8. 18 g vs. 46. 58 +/- 9. 8 g among those who were inactive (p=0. 06). The Kuwaiti adolescent girls were found to have a lower LS-BMC compared to their Lebanese, British and Caucasian Canadian counterparts. Given their vitamin D deficiency, hyperparathyroidism, relatively low LS-BMC, inactive lifestyle and unhealthy eating habits, the Kuwaiti adolescent girls may face an increased risk for developing osteoporosis at an early stage in life. There is an urgent need for population-based health strategies to: (1) raise awareness on the significance of vitamin D to general health; (2) stimulate a healthier lifestyle, especially among adolescent girls.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".