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Ten-Year Trends in Serum 25-Hydroxyvitamin D in Slovenia (2014-2023): Laboratory-Based Data from Tested Individuals
Joško Osredkar1,2, Darko Siuka3, Aleš Jerin1,2
1Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Zaloška Cesta 2, 1000 Ljubljana, Slovenia.
Background:
Vitamin D status is influenced by season, age, and public health messaging. The COVID-19 pandemic was accompanied by heightened interest in vitamin D, but long-term national data from Central/Eastern Europe remain limited. We aimed to characterize 10-year trends, seasonal variation, and demographic determinants of serum 25-hydroxyvitamin D [25(OH)D] in Slovenia, with particular focus on changes during the COVID-19 period.
Methods:
We performed a retrospective cross-sectional analysis of all serum 25(OH)D measurements performed at the Slovenian national reference laboratory between January 2014 and December 2023. The core analytic cohort included 106,875 patients with valid 25(OH)D results, aged 0-100 years. Vitamin D status was classified as deficient (<30 nmol/L), insufficient (30-50 nmol/L), adequate (50-75 nmol/L), and optimal (>75 nmol/L). Temporal trends, seasonal patterns, and age- and sex-specific differences were assessed using non-parametric tests and Kendall's τ.
Results:
Mean 25(OH)D concentration over the study period was 61.9 ± 34.2 nmol/L; 16.0% of patients were deficient and 22.8% insufficient. Annual mean 25(OH)D increased from 57.0 nmol/L in 2014 to 67.2 nmol/L in 2023, with a significant upward temporal trend and a 14.6% higher mean level during 2020-2023 compared with 2014-2019. Seasonal variation was pronounced (≈20% higher summer-autumn vs. winter-spring), and vitamin D status declined progressively with age, with the highest deficiency prevalence in patients ≥ 70 years. Females had slightly higher 25(OH)D than males, although absolute differences were small.
Conclusions:
This laboratory-based analysis of tested patients showed higher 25(OH)D concentrations during and after the COVID-19 period, superimposed on persistent seasonal and age-related gradients. These observations identify older adults and winter testing periods as important contexts for vitamin D optimization, but they should be interpreted as descriptive trends among tested individuals rather than as evidence of causal pandemic effects or population-wide prevalence changes.
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