1. Vitamin D status and cardio-metabolic risk factors in Saudi Arabia
Mrs Najlaa Aljefree* Dr Patricia Lee* Dr Jamal M Al saqqaf† Dr Faruk Ahmed*
*School of Medicine, Menzies Health Institute Queensland, Griffith University, Australia
†Department of Cardiology, King Abdulla Medical City, Saudi Arabia

2. Introduction
Vitamin D deficiency or insufficiency is widespread across the globe with the highest rates of vitamin D deficiency have been reported in sunny regions such as Asia and the Middle East.
A recent national survey in Saudi Arabia showed that almost 40% of males and 60% of females had vitamin D deficiency (<28 ng/ml).
In Saudi Arabia, several studies among Saudi adults have shown high rates of cardio-metabolic risk factors including obesity (35.6%), hypertension (26.1%), diabetes (23.7%), and hypercholesterolemia (50%).
According to the International Diabetes Federation (IDF), Saudi Arabia is one of the countries with the highest number of estimated diabetic subjects in the world.
In addition, a high prevalence of coronary heart disease (CHD) has been reported in the Saudi population (5.5%). The Global Burden of Disease (GBD 2010) data showed that CHD was the leading cause of death in Saudi Arabia in 1990, 2005, and 2010.

3. Cardio-metabolic risk factors (obesity, DM, HTN, and HC)
Aim of the study
The aim of this study was to examine the association between vitamin D deficiency and cardio-metabolic risk factors among adults with CHD and without CHD in Saudi Arabia.
Cardio-metabolic risk factors (obesity, DM, HTN, and HC)
CHD
Vitamin D status
Figure 1: Associations between study variables

4. Methods
Data collection took place between May and October 2015 during summertime in the two large cities in the western region of Saudi Arabia, Jeddah, and Makkah.
A total of 130 CHD subjects and 195 controls were recruited from three hospitals in the Kingdom. The study protocol was approved by the Griffith University Human Research Ethics Committee and Research Ethics Committee in the hospitals.
All included subjects were Saudis or residents in KSA for at least five years. Subjects with medical conditions that may potentially affect vitamin D metabolism such as osteoporosis, liver disease, kidney disease, hyperthyroidism and hyperparathyroidism were excluded.
Face-to-face interviews were conducted with all participants using a structured questionnaire. Data were collected on participants’ sociodemographic characteristics, such as age, gender, and marital status.
Fasting blood samples were collected from each subject to measure serum levels of vitamin D, DM, and HC. Anthropometric and HTN were also measured.

5. Results
Figure 2: the prevalence of cardio-metabolic risk factors among subjects with CHD and subjects without CHD.
Vitamin D deficiency [serum 25(OH)D < 20 ng/mL] was associated with increased risk of diabetes in CHD subjects (OR: 2.9, 95% CI: , p = 0.04), while there was no association observed in subjects without CHD.
No significant association was found between vitamin D deficiency and other cardio-metabolic risk factors (obesity, DM, HC) in either group.

6. Conclusion
The study revealed that vitamin D deficiency was associated with a higher risk of diabetes only among subjects with CHD, but not subjects without CHD. Further studies are needed to confirm these findings.
This study has been published in:
Aljefree NM, Lee P, Saqqaf JMA, Ahmed F (2016) Association between Vitamin D Status and Cardio-Metabolic Risk Factors among Adults with and without Coronary Heart Disease in Saudi Arabia. J Diabetes Metab 7: 707. doi: /