Vitamin D  is soluble prohormone in lipids, key role to facilitate calcium and phosphate absorption [1,2], which are crucial for bone formation and skeletal development. Vitamin D is realized in many people as “sunshine” vitamin, few understand how to boost their intake or are mindful of its frequent health advantages.

Vitamin D is synthesized in plants and invertebrates and vertebrate sources. There five sorts of  D vitamin, the most elaborate in details are D [2,3]. Ergocalciferol D2, is created in plants and invertebrates such as fungi and is available in nutrition and complements treatments, whereas D3, or cholecalciferol, is originated from vertebrate sources like meat, eggs and fish. Master provenance of vitamin is its production inside skin, where D3 provitamin is transformed to vitamin D3 under exposure to (UV) ultraviolet light. Nutritional consumption of vitamin (from D3 in nutrients and D2 in supplements) provides only a smaller contribution to the body’s overall vitamin D levels. [4]. The transformation process occurs in the liver By 25-hydroxyvitamin D-1α-hydroxylase enzyme producing 25-hydroxy vitamin D3, which helps assess vitamin D levels in individuals.  In the kidneys the 25-hydroxy vitamin D transformed to 1,25 dihydroxy vitamin D, which is its active shape ̎calcitriol̎ [5].  

Hypovitaminosis D or commonly known as̎ Vitamin D deficiency̎. Ranks of  ̎vitamin D̎ are  fall beneath the reference range. Fewer than 20 ng/mL of serum vit d means the individual dignosed with hypovitaminosis D  [6]. ̎Vitamin D deficiency̎ is generic through the world [7,8]. Aboutt 50% of population in developing nations are suffering from Hypovitaminosis D. This deficiency is related to frequent health concerns, for example cardiovascular disease [9],  both types of diabetes [10], rheumatoid arthritis and chronic renal disease [11], heightened cancer hazard, ̎depression̎ ,̎cognitive dysfunction̎, and ̎schizophrenia̎. [12]. laterally with ̎rickets in children̎ and ̎osteomalacia̎ in grown persons [13]. Additionally, due to its immune modulation capabilities Vitamin D might play a role in termination risk [14] and its potential indication in the maternal-fetal immune response [15].

Limited sunlight exposure, darker skin, older age, wearing clothing that covers the body, obesity, and being female . All preceding conditions may lead to increase proportion of vitamin D deficiency [16]. various infectious diseases, including microorganism infections are linked to vitamin D inadequacy. the group with human brucellosis had an average sera vitamin D value was (19.91) ng/mL, while the control clutch's was (22.87) ng/mL, rendering to an Iranian case-control research,  ̎A study conducted at Pakistan's Ayub Teaching Hospital obtained 202 patients who nagged of continual aches had an elevated frequency of ̎vitamin D insufficiency̎ [17].  In Iraq a combination of VDD and VD insufficiency confuses a major public health issue related to various chronic diseases [18,19]. This study intends to evaluate the prevalence an inadequacy of vitamin D  among patients at Merjan Hospital in Babylon, Iraq. It also seeks to survey the unknown factors connected with potential risks for vitamin D deficiency. 

Topics and study Zone

A cross-sectional study  was taken place in Babylon, Iraqi city situated in Middle Euphrates  regions. It included 60 cases of hypovitaminosis D ; 23 males and 37 females at age average 40.4 years old .Additionally, 30 control cases of vitamin D3 14 men and 16 women averaged 41.4 years old, Every participant was selected one after the other during normal check-ups in a single-consultation outpatient facility. A questionnaire was used to collect patient information, including name, home address, gender, age, smoking status, chronic disease history, weight, height, and. duration of vitamin D supplementation. ELISA kit Determination. 

Statistical Analysis

Results were offered as or as percentages for normally distributed variables, with data shown as mean ± standard deviation. Analysis of variance ANOVA, the Kruskal-Wallis test, the Wilcoxon test (if applicable), and subsequent post hoc tests were used to contrast the description statistical parameters values for research variables. Analyses were achieved by SPSS program (version 15). Various delivery methods were utilized, including osmotic, electrolytic, or peristaltic driven. By BioMEMS technology, enhancing accuracy precision and compared to mechanically controlled pumps. To ensure a longer lifespan and better biocompatibility, the BioMEMS device will need to incorporate biodegradable polymers or agents that reduce tissue response to the implant, such as anti-inflammatory or antibiotics substances.

In this study, we explored a sample of 60 individuals: 37 females (62.16%) and 23 males (37.84%), ranging in age from 20 to 70 years (see Table 1). The average age of members was 40.4 years, with a median of 14 years. This cross-sectional analysis included 30 control cases of vitamin D3—14 male and 16 female—with an average of age 41.4 years (mean deviation 14, and age range of 15-60). The incidence of Hypovitaminosis D across genders in this population is detailed in Table 1. Conclusions indicated that when considering ≥15 ng/mL as sufficient, nearly half (49.5%) of individuals remained deficient. With respect to Body Mass Index (BMI), it was observed that approximately 30% of subjects displayed an abnormal BMI, with 18.3% categorized as overweight and 11.4% identified as underweight. A comparative analysis between genders indicated higher ranks of Vitamin D and a superior prevalence of dental caries in female patients; conversely, age and BMI did not demonstrate significant differences between the two groups. 

A deficiency ratios categorized by gender stood at 37.84% for males and 62.16% for females [p=0.04]. In an analysis of hypovitaminosis D among different age clutches—10-39, 40-59, and 60-70 years—the younger group showed significantly higher levels (p=0.001) (Table 2).

In the fall and winter, 17.8% of people had a mild vitamin D insufficiency, 23.7%  owned moderate deficiency, also 30.5% owened a severe deficiency. In spring and summer, the prevalence rates for vitamin D deficiencies in adults were 22.7% for mild, 24.2% for moderate, and 26.0% for severe cases. Crucially, autumn and winter had significantly higher rates of severe vitamin D deficiency than spring and summer (p=0.001).   In general, the colder months had greater rates of vitamin D insufficiency.

Table 1: characteristics and lab results of the study’s participants

Table2. Vitamin D in adult Iraqi persons (n=60) compared to healthy adults in different age groups

The consequences indicate of females are more vulnerable than men to Hypovitaminosis D, especially when the lack is severe.  (Table 1). Regardless of being a sunny city, Babylon experiences limited direct sunlight exposure. Legislation mandates that all women wear scarves and long-sleeved attire, contributing to upper prevalence of Hypovitaminosis D among them. Conversely, most men also don long-sleeved shirts, particularly those employed in government sectors. The fear of skin cancer leads many to apply sunscreen on their faces. Additionally, the rise in apartment living, driven by the growing population and a preference for urban life, further limits sun exposure in Iraq.

Hypovitamiosis D is the furthermost dominant medical issue comperhensive, affecting nearly billion individuals [21]. Vitamin D deficiency among adults is reported at 14-59%, chiefly prevalent in Asian states [22-19]

Numerous studies conducted in Iraq and with different age groups had been established that Hypovitaminosis D is quite current [13-17]. A related study in Hilla City targeting individuals aged 20-64 found  9.5%, 57.6%, and 14.2% prevalence of severe, moderate, and mild Hypovitaminosis D, respectively, as reported by Hashemipour et al [14].

Comparing data from different research is challenging due to differences in measuring procedures for 25-OHD concentrations and definitions of vitamin D insufficiency. the findings, submitted that severe vitamin D insufficiency is becoming extra public. Values  of 25-OHD median blood were found to be males 12.4 ng/mL and  females 10.8 ng/mL in a study conducted in Norway involving five significant immigrant clusters, including Iranians. This suggests that women had much lower levels than men [23].

According to this study, women were more likely than males to have a median concentration of 25-OHD and to have vitamin D deficiency, but not insufficiency. Although comparable results have been found in other studies, in some ethnic groups, the causes causing vitamin D insufficiency may differ more between men and women.  Outdoor activities and dress rules, such wearing veils, are also quite important.  Numerous studies show that vitamin D insufficiency was popular in veiled women [25, 24].

Current study found that Hypovitaminosis D was considerably more public in younger persons. reciprocally, many studies had offered that elderly people tend to possess an upper prevalence of deficiency [26,27,28[. The results may stem from vitamin D Complement ̎supplementation̎ in aged individuals, mostly women, who frequently take multivitamins. Additionally, way of life changes among younger individuals could fairly account for these findings. Younger individuals typically reside in apartments and partake in limited outdoor physical activities. In contrast, older adults have a tendency to live in houses and were generally more active outdoors in their youth.

This study determined that factors such as age, gender, and season influence Vitamin D levels among the Babylon population. Therefore, it is advised that routine Vitamin D testing be mandatory for Babylon's residents. The findings suggested the lower rates of Hypovitaminosis D observed in older adults may result from vitamin D supplementation or a broader array of dietary sources. Notably, high deficiency rates were prevalent among Iraqi patients, particularly in older individuals, females, and those with diabetes or hypertension, despite abundant sunshine. Public health initiatives are urgently needed to tackle these deficiency rates, which should include Vitamin D screening, food fortification, and health education to promote sunlight exposure.

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