Determinants of Vitamin D Status: An Analysis in a Primary Care Setting in Lithuania of Age, Gender and Seasonality

Background and Objectives: Vitamin D deficiency is a pervasive public health issue in high-latitude regions, yet large-scale population data for the Baltic states remain sparse. This study aimed to determine the prevalence of vitamin D status and identify its primary determinants within a primary care setting in Lithuania. Materials and Methods: We conducted a retrospective cross-sectional analysis of serum 25-hydroxyvitamin D [25(OH)D] concentrations from 14,330 unique patients (aged 1-101 years) collected during 2025 at a major clinic in Vilnius. Vitamin D status was categorized according to the Central and Eastern European Expert Consensus thresholds. Results: The overall median 25(OH)D concentration was 68.3 nmol/L, placing it in the "insufficiency" range (50-75 nmol/L). Seasonality emerged as the most significant predictor of deficiency; multivariable logistic regression showed a maximal risk reduction in September (OR 0.33; 95% CI: 0.27-0.41) and August (OR 0.34) compared to January, while June and November provided no significant protection. Age-specific analysis revealed a non-linear "U-shaped" distribution: children aged 0-6 years had the highest levels (median ~87-91 nmol/L), likely due to rickets prophylaxis, whereas adolescents (12-18 years) exhibited the highest vulnerability, with approximately 80% suffering from deficiency or insufficiency. Males faced a 13.9% higher likelihood of deficiency than females (OR 1.14; p = 0.0036), potentially due to lower rates of elective supplementation. Conclusions: These findings suggest that current supplementation strategies successfully protect infants but fail to sustain adequacy through adolescence and adulthood, particularly during the "vitamin D winter." Targeted public health interventions for adolescents and year-round monitoring are recommended to mitigate the high prevalence of suboptimal vitamin D status in Lithuania.