Vitamin D, Parathormone and Associated Minerals among Students in Zagazig District, Sharkia Governorate, Egypt.

AIM: To determine the prevalence of vitamin D deficiency and associated factors among students of age 13-18 years. DESIGN: Community-based cross sectional survey. SETTING: Two schools were selected using multistage sampling techniques. SAMPLING: Cluster sampling of all enrolled students (550 students). OUTCOME MEASURES: Serum levels of 25-hydroxyvitamin D (25 OHD), parathyroid hormone and calcium. Data was collected about nutritional intake, physical activity and lifestyle variables that are potential risk factors for hypovitaminosis D. RESULTS: Hypovitaminosis D prevalence was 23.8%, of which 5.3% was deficiency and 18.5% insufficiency. Serum 25 OHD levels inversely correlated with parathyroid hormone levels (r=-0.206, P= 0.00). Low calcium and ionized calcium levels were 40.6% and 45.9%, respectively, and significantly correlated with vitamin D levels. Female students have significantly higher levels of hypovitaminosis D compared to males (29.3% to 15.0%, respectively) and the level of vitamin D significantly improved with increased age. Exposure to sun had a significant effect on vitamin D levels, and physical activity, soft drink consumption and smoking did not. Multinomial regression analysis revealed that age, sun exposure and Ca level were the only significant independent predictors of hypovitaminosis D among the studied group. CONCLUSION: Our findings revealed that hypovitaminosis D is a prevalent health problem in adolescents, especially girls, who were at higher risk, and increased age and sun exposure improved vitamin D status among the studied group. There is therefore a need to consider vitamin D supplementation for school children together with increased awareness through a health education program.

Loneliness among women with rheumatoid arthritis: a cross-cultural study in the Netherlands and Egypt.

The objective of this study was to explain loneliness as experienced by women with rheumatoid arthritis (RA) in a cross-cultural context. We studied 36 Egyptian female RA patients and 140 female Dutch RA patients.. Self-report data were collected about loneliness, physical and psychological health status, social support and social network, needs for help, attitudes and feelings of guilt. Loneliness was significantly higher among Egyptian (44.2 +/- 32.3) than Dutch (12.9 +/- 18.9) female RA patients (F = 54.3, p < 0.001). In Egypt, 36% of the variance of loneliness could be explained by worse affect (anxiety and depression; beta = 0.51), fewer children (beta = 0.31), and higher negative social support for the patients (beta = 0.28) in multiple regression analysis. In the Netherlands, 35% of feeling lonely could be explained by worse affect scores (beta = 0.52), less positive social support for the patients (beta = 0.24), and a higher degree of disability (beta = 0.21). Age of the patients and disease duration only explained 4% and 3% of the loneliness of RA patients in Egypt and the Netherlands, respectively. Female Egyptian RA patients experienced more loneliness than Dutch patients. Affect is the most important and constant variable in explaining loneliness in both countries. The role of the family in perceived loneliness is greater in Egypt than the Netherlands. Low social support received by patients is important in explaining loneliness in the Netherlands but not in Egypt.