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Sun exposure behaviour, seasonal vitamin D deficiency, and relationship to bone health in adolescents
Farrar, M.D. ; Mughal, M.Z. ; Adams, Jenny E. ; Wilkinson, J. ; Berry, J.L. ; Edwards, Lisa ; Kift, R. ; Marjanovic, E. ; Vail, A. ; Webb, A.R. ... show 1 more
Farrar, M.D.
Mughal, M.Z.
Adams, Jenny E.
Wilkinson, J.
Berry, J.L.
Edwards, Lisa
Kift, R.
Marjanovic, E.
Vail, A.
Webb, A.R.
Publication Date
2016-08-01
End of Embargo
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© 2016 by the Endocrine Society. Reproduced in accordance with the publisher's self-archiving policy.
This is a pre-copy-editing, author-produced PDF of an article accepted for publication in The Journal of Clinical Endocrinology & Metabolism following peer review. The definitive publisherauthenticated version [Farrar MD, Mughal MZ, Adams JE et al (2016) Sun exposure behaviour, seasonal vitamin D deficiency, and relationship to bone health in adolescents. The Journal of Clinical Endocrinology & Metabolism. 101(8): 3105-3113.] is available online at: https://doi.org/10.1210/jc.2016-1559
Peer-Reviewed
Yes
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openAccess
Accepted for publication
2016-05-20
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Abstract
Context: Vitamin D is essential for bone health in adolescence, where there is rapid bone mineral
content accrual. As cutaneous sun-exposure provides vitamin D, there is no recommended oral intake
for UK adolescents.
Assess seasonal vitamin D status and its contributors in white Caucasian adolescents, and
examine bone health in those found deficient.
Design: Prospective cohort study.
Setting: Six schools in Greater Manchester, UK.
Participants: 131 adolescents, 12–15 years.
Intervention(s): Seasonal assessment of circulating 25-hydroxyvitamin D (25OHD), personal sunexposure
and dietary vitamin D. Adolescents deficient (25OHD <10 ng/mL/25 nmol/L) in ≥one
season underwent dual-energy X-ray absorptiometry (lumbar spine, femoral neck), with bone mineral
apparent density (BMAD) correction for size, and peripheral quantitative computed tomography
(distal radius) for volumetric (v)BMD.
Main Outcome Measure: Serum 25OHD; BMD.
Results: Mean 25OHD was highest in September: 24.1 (SD 6.9) ng/mL and lowest in January: 15.5
(5.9) ng/mL. Over the year, 16% were deficient in ≥one season and 79% insufficient (25OHD <20
ng/mL/50 nmol/L) including 28% in September. Dietary vitamin D was low year-round while
personal sun-exposure was seasonal and predominantly across the school week. Holidays accounted
for 17% variation in peak 25OHD (p<0.001). Nineteen adolescents underwent bone assessment,
which showed low femoral neck BMAD versus matched reference data (p=0.0002), 3 with Z≤ -2.0
distal radius trabecular vBMD.
Conclusions: Sun-exposure levels failed to provide adequate vitamin D, ~one-quarter adolescents
insufficient even at summer-peak. Seasonal vitamin D deficiency was prevalent and those affected
had low BMD. Recommendations on vitamin D acquisition are indicated in this age-group.
Version
Accepted manuscript
Citation
Farrar MD, Mughal MZ, Adams JE et al (2016) Sun exposure behaviour, seasonal vitamin D deficiency, and relationship to bone health in adolescents. The Journal of Clinical
Endocrinology & Metabolism. 101(8): 3105-3113.
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Article