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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.
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
Open Access status
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