High prevalence of vitamin D deficiency among Ethiopian women immigrants to Israel: exacerbation during pregnancy and lactation

Isr J Med Sci. 1995 Apr;31(4):221-4.

Abstract

A population of 125 adult Ethiopian women immigrants to Israel was screened for serum levels of calcium, phosphorus, and alkaline phosphatase. Five women (prevalence of 4%) had hypocalcemia and in one of them osteomalacia was found. In the other 120 subjects normal values were recorded. All five patients had low serum levels of 25 hydroxy (OH) vitamin D3 and high parathyroid hormone (PTH) levels. In four of the five patients, clinical and biochemical manifestations of vitamin D deficiency were detected during pregnancy or lactation. Treatment with vitamin D2 for 4-13 months resulted in clinical improvement and partially corrected the biochemical abnormalities, but low serum vitamin D levels and elevated PTH levels persisted. We conclude that vitamin D deficiency among female Ethiopian immigrants to Israel can be ascribed either to dark skin or low calcium and vitamin D intake, or both. As far as we known this is the first report of vitamin D deficiency among such immigrants. Our study suggests the need to be alert to the possibility of vitamin D deficiency in Ethiopian women who have immigrated to Israel, in particular those who are pregnant or are breast-feeding.

PIP: A population of 125 adult Ethiopian women immigrants to Israel was screened for serum levels of calcium, phosphorus, and alkaline phosphatase. After the first instance of hypocalcemia was observed at a clinic in Afula Ilit (northern Israel), case finding was initiated among the 131 adult Ethiopian subjects 20 years or older. Over the course of 4 years, 125 patients (95%) were investigated. In 5 patients for whom these values deviated from the norm, values of parathyroid hormone (PTH), 1,25 hydroxy (OH) D, and 25 OH D were determined. Their diet was assessed for vitamin D-fortified foods and calcium intake. 5 subjects (prevalence of 4%) had hypocalcemia with normophosphatemia, 2 of them also having elevated levels of alkaline phosphatase. In 1 of them osteomalacia was found. Before and after treatment, high serum PTH and 1,25 OH D and low 25 OH D were found in all patients. All 5 patients had low serum levels of 25 hydroxy (OH) vitamin D3 and high parathyroid hormone (PTH) levels. In 4 of the 5 patients, clinical and biochemical manifestations of vitamin D deficiency were detected during pregnancy or lactation. Treatment with vitamin D2 for 4-13 months resulted in clinical improvement and partially corrected the biochemical abnormalities, but low serum vitamin D levels and elevated FTH levels persisted. Vitamin D deficiency among female Ethiopian immigrants to Israel can be ascribed either to dark skin or to low calcium and vitamin D intake, or to both. As far as it is known this is the first report of vitamin D deficiency among such immigrants. The study suggests the need to be alert to the possibility of vitamin D deficiency in Ethiopian women who have immigrated to Israel, in particular those who are pregnant or are breast-feeding.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Breast Feeding
  • Emigration and Immigration
  • Ethiopia / ethnology
  • Female
  • Humans
  • Hypocalcemia / ethnology
  • Israel / epidemiology
  • Jews
  • Lactation*
  • Pregnancy
  • Pregnancy Complications / ethnology*
  • Prevalence
  • Vitamin D Deficiency / diagnosis
  • Vitamin D Deficiency / ethnology*
  • Vitamin D Deficiency / therapy