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Badiu Tișa I, Cozma-Petruț A, Samașca G, Miere D, Filip L, Banc R, Mîrza O, Iancu M. Vitamin D Status among 2-18-Year-Old Romanian Pediatric Patients: A Single-Center Study. Nutrients 2024; 16:2266. [PMID: 39064709 PMCID: PMC11280053 DOI: 10.3390/nu16142266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
An adequate vitamin D level is essential for optimal bone mass formation during growth. The present study aimed to assess (i) the sex-specific, age-specific, and potential seasonal (spring, summer, winter) influences on the pediatric circulating levels of 25-hydroxyvitamin D (25(OH)D); (ii) determine the frequency of pediatric patients with vitamin D deficiency (VDD) or insufficiency (VDI); and (iii) quantify the association between age category, sex, and season types and susceptibility to VDD and VDI, respectively. Laboratory data were collected on serum 25(OH)D levels in children aged between 2 and 18 years (n = 1674) who underwent blood sampling following admission to a university pediatric hospital in Cluj-Napoca (Romania) between January and June 2023. VDD (<20 ng/mL) was observed in 27% of pediatric patients. Among toddlers and preschoolers (2-5 years), VDD was 11%, while it was 33% among school-aged children (6-11 years) and 39% among adolescents (12-18 years). We found a significant difference in the frequencies of vitamin D status between females and males (p = 0.006). Also, we found significant associations of vitamin D status with age categories (p < 0.0001) and seasonal variations (p = 0.03). After adjusting for season of blood collection, the multinomial logistic regression model showed that children aged 6-11 years old (adjusted OR = 7, 95% CI: (4.9, 9.4)), children aged 12-18 years old (adjusted OR = 14, 95% CI: (9.3, 19.6)), and females (adjusted OR = 1.43, 95% CI: (1.10, 1.86)) were significantly associated with higher odds of VDD. In conclusion, the study revealed a significant difference in the frequency of VDD and VDI among pediatric patients older than six years, with a significant difference according to sex and season, being more pronounced among girls and during the winter and spring seasons.
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Affiliation(s)
- Ioana Badiu Tișa
- Department of Mother and Child Care, “Iuliu Hațieganu” University of Medicine and Pharmacy, 2-4 Câmpeni Street, 400217 Cluj-Napoca, Romania;
| | - Anamaria Cozma-Petruț
- Department of Bromatology, Hygiene, Nutrition, “Iuliu Hațieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania; (D.M.); (L.F.); (R.B.); (O.M.)
| | - Gabriel Samașca
- Department of Functional Biosciences, Immunology and Allergology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 19-21 Croitorilor Street, 400162 Cluj-Napoca, Romania;
| | - Doina Miere
- Department of Bromatology, Hygiene, Nutrition, “Iuliu Hațieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania; (D.M.); (L.F.); (R.B.); (O.M.)
| | - Lorena Filip
- Department of Bromatology, Hygiene, Nutrition, “Iuliu Hațieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania; (D.M.); (L.F.); (R.B.); (O.M.)
- Academy of Romanian Scientists (AOSR), 3 Ilfov Street, 050044 Bucharest, Romania
| | - Roxana Banc
- Department of Bromatology, Hygiene, Nutrition, “Iuliu Hațieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania; (D.M.); (L.F.); (R.B.); (O.M.)
| | - Oana Mîrza
- Department of Bromatology, Hygiene, Nutrition, “Iuliu Hațieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania; (D.M.); (L.F.); (R.B.); (O.M.)
| | - Mihaela Iancu
- Department of Medical Informatics and Biostatistics, “Iuliu Hațieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania;
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Secondulfo C, Visco V, Virtuoso N, Fortunato M, Migliarino S, Rispoli A, La Mura L, Stellato A, Caliendo G, Settembre E, Galluccio F, Hamzeh S, Bilancio G. Vitamin D: A Bridge between Kidney and Heart. Life (Basel) 2024; 14:617. [PMID: 38792638 PMCID: PMC11123235 DOI: 10.3390/life14050617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/30/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
Chronic kidney disease (CKD) and cardiovascular disease (CVD) are highly prevalent conditions, each significantly contributing to the global burden of morbidity and mortality. CVD and CKD share a great number of common risk factors, such as hypertension, diabetes, obesity, and smoking, among others. Their relationship extends beyond these factors, encompassing intricate interplay between the two systems. Within this complex network of pathophysiological processes, vitamin D has emerged as a potential linchpin, exerting influence over diverse physiological pathways implicated in both CKD and CVD. In recent years, scientific exploration has unveiled a close connection between these two prevalent conditions and vitamin D, a crucial hormone traditionally recognized for its role in bone health. This article aims to provide an extensive review of vitamin D's multifaceted and expanding actions concerning its involvement in CKD and CVD.
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Affiliation(s)
- Carmine Secondulfo
- Department “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy
| | - Valeria Visco
- Department “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy
| | - Nicola Virtuoso
- Cardiology Unit, Salerno University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Martino Fortunato
- Cardiology Unit, Salerno University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Serena Migliarino
- Cardiology Unit, Salerno University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Antonella Rispoli
- Cardiology Unit, Salerno University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Lucia La Mura
- Centro Medico Ascione Srl, 80059 Torre del Greco, Italy
| | - Adolfo Stellato
- Department “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy
| | - Giuseppe Caliendo
- Department “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy
| | - Emanuela Settembre
- Department “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy
| | - Fabiana Galluccio
- Department of Medicine and Surgery, University of Naples “Federico II”, 80138 Napoli, Italy
| | - Sarah Hamzeh
- Department of Medicine and Surgery, University of Naples “Federico II”, 80138 Napoli, Italy
| | - Giancarlo Bilancio
- Department “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy
- Nephrology Unit, Salerno University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
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Miller KM, Lucas RM, Davis EA, Hart PH, de Klerk NH. Use of linked administrative and laboratory data to confirm that serum 25(OH)D levels in pregnant women can be predicted from satellite estimates of ultraviolet radiation. Int J Epidemiol 2021; 50:303-313. [PMID: 33221879 DOI: 10.1093/ije/dyaa165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Serum 25 hydroxyvitamin D [25(OH)D] levels of pregnant women have been linked to various health outcomes in their offspring. Satellite-derived ultraviolet radiation (UVR) data have been used as a proxy for 25(OH)D levels, as individual-level cohort studies are time-consuming, costly and only feasible for common outcomes. METHODS Data on 25(OH)D levels from a public laboratory database were linked to data from the Western Australian Midwives' Notification System and daily erythemal UVR dose from NASA satellites. Regression analysis was used to identify the time period prior to venesection where daily UVR dose best predicted 25(OH)D levels. A predictive model was used to validate the use of daily UVR dose as a proxy for personal sun exposure during pregnancy. RESULTS Data from 19 173 pregnancies in women aged 18-43 years in Western Australia were included. The daily UVR dose averaged over the 90 days before venesection was the strongest UVR predictor of 25(OH)D level (a 5% increase per 1000 J m-2; equal to 3.3 nmol L-1 at the median of 66 nmol L-1). Ethnicity was the strongest predictor of 25(OH)D levels (21% lower in non-Caucasian vs Caucasian: equal to 7.2 nmol L-1 difference). Other significant predictors were gestation, age, year, parity, socio-economic status, remoteness, medical conditions and season. CONCLUSION NASA-derived erythemal UVR dose in the 90 days prior to venesection is a significant predictor of 25(OH)D levels in pregnant women. Linked administrative data can be used to investigate associations between UVR during pregnancy and health outcomes in offspring.
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Affiliation(s)
- Kate M Miller
- University of Western Australia, Perth, Western Australia.,Telethon Kids Institute, Perth, Western Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia.,Centre for Ophthalmology and Visual Sciences, University of Western Australia, Perth, Australia
| | - Elizabeth A Davis
- Telethon Kids Institute, Perth, Western Australia.,Perth Children's Hospital, Perth Australia
| | - Prue H Hart
- Telethon Kids Institute, Perth, Western Australia
| | - Nicholas H de Klerk
- University of Western Australia, Perth, Western Australia.,Telethon Kids Institute, Perth, Western Australia
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Karamizadeh M, Seif M, Holick MF, Akbarzadeh M. Developing a Model for Prediction of Serum 25-Hydroxyvitamin D Level: The Use of Linear Regression and Machine Learning Methods. J Am Coll Nutr 2021; 41:191-200. [PMID: 33555236 DOI: 10.1080/07315724.2020.1869624] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Because vitamin D status affects many organs and tissues of the body, it is important to determine the factors affecting it. The purpose of this study was to develop a model for predicting the serum 25-hydroxyvitamin D [25(OH)D] level in healthy young adults. METHOD This cross-sectional study was conducted on 201 healthy individuals aged 20 to 40 years old in Shiraz, Iran. Data regarding demographic characteristics, vitamin D intake through supplements, and sun exposure habits were gathered. Serum 25(OH)D concentration was also measured. Data were analyzed with R software using linear regression and different machine learning methods such as conditional tree, conditional forest and random forest. RESULTS Based on the linear regression, male sex (p < 0.001), taking 50,000 IU vitamin D3 supplement monthly (p < 0.001), and lower waist circumference (p = 0.018) were identified as effective factors in increasing serum 25(OH)D levels. According to the conditional tree, taking 50,000 IU vitamin D3 supplement monthly (p < 0.001) and sex (p < 0.001) were two main factors in the classification of individuals in terms of serum 25(OH)D levels. Besides, conditional forest and random forest results showed that the most important variable was taking 50,000 IU vitamin D3 supplement monthly. CONCLUSIONS Supplement use is the first and most important predictor of 25(OH)D levels and other factors, including sex and waist circumference, are ranked thereafter, and the importance of these factors is greater in those who do not take vitamin D3 supplements.
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Affiliation(s)
- Malihe Karamizadeh
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mozhgan Seif
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Michael F Holick
- Section Endocrinology, Diabetes, Nutrition and Weight Management, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Marzieh Akbarzadeh
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Barsoum R, Harrison SL. Clinical Characteristics in Early Childhood Associated with a Nevus-Prone Phenotype in Adults from Tropical Australia: Two Decades of Follow-Up of the Townsville Preschool Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228680. [PMID: 33238422 PMCID: PMC7700251 DOI: 10.3390/ijerph17228680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/09/2020] [Accepted: 11/12/2020] [Indexed: 11/25/2022]
Abstract
Having numerous melanocytic nevi increases melanoma risk. Few studies have enumerated nevi in children and re-examined them as adults. We aimed to determine if childhood nevus-counts predict nevus-prone adults, and further explore the relevance of host-factors and sun-exposure. Fifty-one Caucasian residents of Townsville (19.16° S, Queensland, Australia) had full-body nevus-counts aged 1–6 and 21–31 years-old. Sun-exposure was determined from questionnaires. Children in the upper-quartile of nevus-counts acquired nevi more rapidly than those in the bottom-quartile (13.3 versus 4.7 nevi/year; p < 0.0005). Children sunburnt before 7 years-old acquired more incident nevi by adulthood (238 versus 126, p = 0.003) particularly if sunburn was severe (321 versus 157.5, p = 0.003) or erythema occurred annually (380 versus 132, p = 0.008). Fair-skinned, freckled children with some nevi ≥ 3 mm, solar lentigines, or a family history of melanoma acquired more incident nevi than children without these attributes. Nevus-prone adults exhibit distinguishing features earlier in life (<7 years-old in Queensland) than has been shown previously. In addition to intervening with sun-protection counselling early enough to reduce risk, being able to reliably triage children into high- and low melanoma-risk groups may inform more efficacious and cost-effective targeted-screening in melanoma-prone populations. Further longitudinal research is needed to confirm that these attributes can reliably separate risk-groups.
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Affiliation(s)
- Ramez Barsoum
- Skin Cancer Research Unit, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville 4811, Australia;
- College of Medicine and Dentistry, James Cook University, Townsville 4811, Australia
- Princess Alexandra Hospital, Queensland Health, Woolloongabba, Brisbane 4102, Australia
| | - Simone L. Harrison
- Skin Cancer Research Unit, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville 4811, Australia;
- College of Medicine and Dentistry, James Cook University, Townsville 4811, Australia
- Correspondence: ; Tel.: +61-(0)423-489-083
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Kimlin MG, Fang L, Feng Y, Wang L, Hao L, Fan J, Wang N, Meng F, Yang R, Cong S, Liang X, Wang B, Linet M, Potischman N, Kitahara C, Chao A, Wang Y, Sun J, Brodie A. Personal ultraviolet Radiation exposure in a cohort of Chinese mother and child pairs: the Chinese families and children study. BMC Public Health 2019; 19:281. [PMID: 30849990 PMCID: PMC6408854 DOI: 10.1186/s12889-019-6610-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 02/28/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Few studies in China have examined personal ultraviolet radiation (UVR) exposure using polysulfone dosimetry. METHODS In this study, 93 mother and adolescent child pairs (N = 186) from two locations in China, one rural (higher latitude) and one urban (lower latitude), completed 3 days of personal UVR dosimetry and a sun/clothing diary, as part of a larger pilot study. RESULTS The average daily ambient UVR in each location as measured by dosimetry was 20.24 Minimal Erythemal Doses (MED) in the rural location and 20.53 MED in the urban location. Rural mothers had more average daily time outdoors than urban mothers (5.5 h, compared with 1.5 h, in urban mothers) and a much higher daily average personal UVR exposure (4.50 MED, compared with 0.78 MED in urban mothers). Amongst adolescents, rural males had the highest average daily personal UVR exposure, followed by rural females, urban females and urban males (average 2.16, 1.05, 0.81, and 0.48 MED, respectively). CONCLUSIONS Although based on small numbers, our findings show the importance of geographic location, age, work/school responsibilities, and sex of the adolescents in determining personal UVR exposure in China. These results suggest that latitude of residence may not be a good proxy for personal UVR exposure in all circumstances.
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Affiliation(s)
- Michael G. Kimlin
- University of the Sunshine Coast, Maroochydore, Faculty of Science, Health, Education and Engineering, Locked Bag 4, Maroochydore DC, Queensland 4558 Australia
- Cancer Council Queensland, Brisbane, Australia
| | - Liwen Fang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 Beijing China
| | - Yajing Feng
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 Beijing China
| | - Linhong Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 Beijing China
| | - Ling Hao
- US Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Jing Fan
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 Beijing China
| | - Ning Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 Beijing China
| | - Fanwen Meng
- Laoting County Maternal and Child Health Hospital, Laoting, Hebei China
| | - Ruilan Yang
- Taicang County Maternal and Child Health Hospital, Taicang, Jiangsu China
| | - Shu Cong
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 Beijing China
| | - Xiaofeng Liang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Baohua Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050 Beijing China
| | - Martha Linet
- National Cancer Institute (NIH) - Division of Cancer Epidemiology and Genetics, Bethesda, MD USA
| | - Nancy Potischman
- National Cancer Institute, Office of Dietary Supplements, Bethesda, MD USA
| | - Cari Kitahara
- National Cancer Institute (NIH) - Division of Cancer Epidemiology and Genetics, Bethesda, MD USA
| | - Ann Chao
- National Cancer Institute, Center for Global Health, Bethesda, MD USA
| | - Yu Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiandong Sun
- University of the Sunshine Coast, Maroochydore, Faculty of Science, Health, Education and Engineering, Locked Bag 4, Maroochydore DC, Queensland 4558 Australia
| | - Alison Brodie
- University of the Sunshine Coast, Maroochydore, Faculty of Science, Health, Education and Engineering, Locked Bag 4, Maroochydore DC, Queensland 4558 Australia
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Swaminathan A, Harrison SL, Ketheesan N, van den Boogaard CHA, Dear K, Allen M, Hart PH, Cook M, Lucas RM. Exposure to Solar UVR Suppresses Cell-Mediated Immunization Responses in Humans: The Australian Ultraviolet Radiation and Immunity Study. J Invest Dermatol 2019; 139:1545-1553.e6. [PMID: 30684553 DOI: 10.1016/j.jid.2018.12.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 12/28/2018] [Accepted: 12/31/2018] [Indexed: 01/27/2023]
Abstract
Animal and human studies show that exposure to solar-simulated UVR is immunomodulatory. Human studies that used natural sun exposure and controlled for confounding are rare. We immunized 217 healthy adults (age range = 18-40 years) with a T-cell-dependent antigen, keyhole limpet hemocyanin, and measured personal clothing-adjusted UVR exposure (for 5 days before and after immunization), lifetime cumulative UVR exposure, serum 25-hydroxyvitamin D concentration at immunization, and potential confounding factors. We tested cellular and humoral immune responses in relation to UVR exposure. The delayed-type hypersensitivity response to keyhole limpet hemocyanin recall challenge was lower in individuals with higher personal clothing-adjusted UVR exposure on the day before immunization (P = 0.015) and during intervals spanning the day before to 2-3 days after immunization. There was an incremental increase in T helper type 17 cells (as a proportion of CD4+ T cells) from preimmunization to postimmunization in the high, compared with the low, personal clothing-adjusted UVR exposure group (0.31% vs. -0.39%, P = 0.004). Keyhole limpet hemocyanin-specific antibody titers were not associated with acute or cumulative UVR exposure or serum 25-hydroxyvitamin D levels. Higher UVR exposure at antigen sensitization was associated with a reduced delayed-type hypersensitivity response and altered T helper type 17 kinetics. This has implications for the effectiveness of vaccinations and susceptibility to infections that rely on cell-mediated immune responses.
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Affiliation(s)
- Ashwin Swaminathan
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia; Departments of General Medicine and Infectious Diseases, The Canberra Hospital, Canberra, Australia
| | - Simone L Harrison
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Natkunam Ketheesan
- Science and Technology, University of New England, School of Science and Technology, University of New England, Armidale, New South Wales, Australia
| | - Christel H A van den Boogaard
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia; University of Adelaide, Adelaide, South Australia, Australia
| | - Keith Dear
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Martin Allen
- Department of Electrical and Computer Engineering, University of Canterbury, Christchurch, New Zealand
| | - Prue H Hart
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Matthew Cook
- Department of Immunology, The Canberra Hospital, Canberra, Australia; Centre for Personalized Immunology, John Curtin School of Medical Research, Australian National University, Canberra, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia; Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia.
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Schmalwieser AW, Siani AM. Review on Nonoccupational Personal Solar UV Exposure Measurements. Photochem Photobiol 2018; 94:900-915. [PMID: 29856894 DOI: 10.1111/php.12946] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/25/2018] [Indexed: 01/22/2023]
Abstract
Solar ultraviolet (UV) radiation follows people during their whole life. Exposure to UV radiation is vital but holds serious risks, too. The quantification of human UV exposure is a complex issue. UV exposure is directly related to incoming UV radiation as well as to a variety of factors such as the orientation of the exposed anatomical site with respect to the sun and the duration of exposure. The use of badge-sensors allows assessing the UV exposure of differently oriented body sites. Such UV devices have been available for over 40 years, and a variety of measuring campaigns have been undertaken since then. This study provides an overview of those studies which reported measurements of the personal UV exposure (PE) during outdoor activities of people not related to their occupation. This overview is given chronologically to show the progress of knowledge in this research and is given with respect to different activities. Special focus is put on the ratio of personal exposure to ambient UV radiation. This ratio, when given as a function of solar elevation, allows estimating PE at any other location or date if ambient UV radiation is known.
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Affiliation(s)
- Alois W Schmalwieser
- Unit of Physiology and Biophysics, University of Veterinary Medicine, Vienna, Austria
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9
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Chlebna-Sokół D, Konstantynowicz J, Abramowicz P, Kulik-Rechberger B, Niedziela M, Obuchowicz A, Ziora K, Karalus-Gach J, Golec J, Michałus I, Karczmarewicz E, Halaba ZP. Evidence of a significant vitamin D deficiency among 9-13-year-old Polish children: results of a multicentre study. Eur J Nutr 2018; 58:2029-2036. [PMID: 29936536 PMCID: PMC6647701 DOI: 10.1007/s00394-018-1756-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 06/20/2018] [Indexed: 10/29/2022]
Abstract
PURPOSE To evaluate the extent to which the population of Polish preadolescents is vitamin D deficient and to assess seasonal variations in vitamin D status. PARTICIPANTS AND METHODS A total of 720 healthy children aged 9-13 years (409 girls, 311 boys) residing in 6 representative geographical locations in Poland were studied. A parental-assisted questionnaire provided data on nutritional habits, vitamin D supplements and sun exposure. Serum concentration of 25-hydroxyvitamin was determined twice, after the winter in March and after the summer in October. RESULTS In March, vitamin D deficiency (25-50 nmol/L) was found in 64%, and severe deficiency (< 25 nmol/L) in 20.2% of children. In October, the deficiency and severe deficiency were still noticed in 25.9 and 0.1% of children, respectively. The mean serum concentration of 25-OHD was 52% higher in October (55.4 ± 14.0 nmol/L) than in March (36.4 ± 13.5 nmol/L), (p < 0.01). In children with 25-OHD < 50 nmol/L in March, their 25-OHD concentration increased by 64% through March to October (32.5 ± 8.2 vs. 53.2 ± 7.9 nmol/L, p < 0.01). An association was found between 25-OHD concentration and regular consumption of vitamin D supplements, cod-liver oil and fish. CONCLUSIONS The majority of preadolescent Polish boys and girls show vitamin D deficiency after the winter period, although a distinct amelioration over summertime is found in this age group. There is a need to implement effective prevention and intervention strategies in the management of vitamin D deficiency among schoolchildren in Poland, with the supplementation throughout the entire year.
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Affiliation(s)
- Danuta Chlebna-Sokół
- Department of Pediatric Propaedeutics and Metabolic Bone Diseases, Medical University of Lodz, Sporna Street 36/50, 91-738, Łódź, Poland
| | - Jerzy Konstantynowicz
- Department of Pediatric Rheumatology, Immunology, and Metabolic Bone Diseases, Medical University of Bialystok, Waszyngtona Street 17, 15-2742, Białystok, Poland
| | - Paweł Abramowicz
- Department of Pediatric Rheumatology, Immunology, and Metabolic Bone Diseases, Medical University of Bialystok, Waszyngtona Street 17, 15-2742, Białystok, Poland
| | - Beata Kulik-Rechberger
- Departament of Paediatric Propaedeutics, Medical University of Lublin, Gębali Street 6, 20-091, Lublin, Poland
| | - Marek Niedziela
- Department of Pediatric Endocrinology and Rheumatology, Poznan University of Medical Sciences, Szpitalna Street 27/33, 60-572, Poznań, Poland
| | - Anna Obuchowicz
- Department of Paediatrics, School of Health Sciences in Katowice, Medical University of Silesia, Batorego Street 15, 41-902, Bytom, Poland
| | - Katarzyna Ziora
- Department of Paediatrics, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 3-go Maja Street 13-15, 41-800, Zabrze, Poland
| | - Jolanta Karalus-Gach
- Department of Pediatric Propaedeutics and Metabolic Bone Diseases, Medical University of Lodz, Sporna Street 36/50, 91-738, Łódź, Poland
| | - Joanna Golec
- Department of Pediatric Propaedeutics and Metabolic Bone Diseases, Medical University of Lodz, Sporna Street 36/50, 91-738, Łódź, Poland
| | - Izabela Michałus
- Department of Pediatric Propaedeutics and Metabolic Bone Diseases, Medical University of Lodz, Sporna Street 36/50, 91-738, Łódź, Poland
| | - Elżbieta Karczmarewicz
- Department of Biochemistry and Experimental Medicine, The Children's Memorial Health Institute in Warsaw, Aleja Dzieci Polskich 20, 04-730, Warsaw, Poland
| | - Zenon Piotr Halaba
- Department of Medical Simulation, University of Opole, Oleska Street 48, 45-052, Opole, Poland.
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10
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Smit AK, Newson AJ, Morton RL, Kimlin M, Keogh L, Law MH, Kirk J, Dobbinson S, Kanetsky PA, Fenton G, Allen M, Butow P, Dunlop K, Trevena L, Lo S, Savard J, Dawkins H, Wordsworth S, Jenkins M, Mann GJ, Cust AE. The melanoma genomics managing your risk study: A protocol for a randomized controlled trial evaluating the impact of personal genomic risk information on skin cancer prevention behaviors. Contemp Clin Trials 2018; 70:106-116. [PMID: 29802966 DOI: 10.1016/j.cct.2018.05.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 05/17/2018] [Accepted: 05/22/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Reducing ultraviolet radiation (UV) exposure and improving early detection may reduce melanoma incidence, mortality and health system costs. This study aims to evaluate the efficacy and cost-effectiveness of providing information on personal genomic risk of melanoma in reducing UV exposure at 12 months, according to low and high traditional risk. METHODS In this randomized controlled trial, participants (target sample = 892) will be recruited from the general population, and randomized (1:1 ratio, intervention versus control). Intervention arm participants provide a saliva sample, receive personalized melanoma genomic risk information, a genetic counselor phone call, and an educational booklet on melanoma prevention. Control arm participants receive only the educational booklet. Eligible participants are aged 18-69 years, have European ancestry and no personal history of melanoma. All participants will complete a questionnaire and wear a UV dosimeter to objectively measure their sun exposure at baseline, 1- and 12-month time-points, except 1-month UV dosimetry will be limited to ~250 participants. The primary outcome is total daily Standard Erythemal Doses at 12 months. Secondary outcomes include objectively measured UV exposure for specific time periods (e.g. midday hours), self-reported sun protection and skin-examination behaviors, psycho-social outcomes, and ethical considerations surrounding offering genomic testing at a population level. A within-trial and modelled economic evaluation will be undertaken from an Australian health system perspective to assess the intervention costs and outcomes. DISCUSSION This trial will inform the clinical and personal utility of introducing genomic testing into the health system for melanoma prevention and early detection at a population-level. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12617000691347.
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Affiliation(s)
- Amelia K Smit
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia; Sydney Health Ethics, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia; Melanoma Institute Australia, The University of Sydney, NSW 2006, Australia.
| | - Ainsley J Newson
- Sydney Health Ethics, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia
| | - Rachael L Morton
- NHMRC Clinical Trials Centre, The University of Sydney, NSW 2006, Australia
| | - Michael Kimlin
- University of the Sunshine Coast and Cancer Council Queensland, PO Box 201, Spring Hill, QLD 4004, Australia
| | - Louise Keogh
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Matthew H Law
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Locked Bag 2000, Brisbane, QLD 4029, Australia
| | - Judy Kirk
- Westmead Clinical School and Westmead Institute for Medical Research, Sydney Medical School, The University of Sydney, NSW 2006, Australia
| | - Suzanne Dobbinson
- Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Peter A Kanetsky
- H. Lee Moffitt Cancer Center and Research Institute and University of South Florida, 4202 E Fowler Ave, Tampa, FL 33620, USA
| | - Georgina Fenton
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia
| | - Martin Allen
- Electrical and Computer Engineering, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, The University of Sydney, NSW 2006, Australia
| | - Kate Dunlop
- The Centre for Genetics Education, NSW Health, Level 5 2c Herbert Street St Leonards, NSW 2065, Australia
| | - Lyndal Trevena
- Sydney School of Public Health, The University of Sydney, NSW 2006, Australia
| | - Serigne Lo
- Melanoma Institute Australia, The University of Sydney, NSW 2006, Australia
| | - Jacqueline Savard
- Sydney Health Ethics, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia
| | - Hugh Dawkins
- Office of Population Health Genomics, Public Health Division, Government of Western Australia, Level 3 C Block 189 Royal Street, East Perth, WA 6004, Australia
| | - Sarah Wordsworth
- Health Economics Research Centre, The University of Oxford, Oxford OX1 2JD, UK
| | - Mark Jenkins
- Centre for Epidemiology & Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Graham J Mann
- Melanoma Institute Australia, The University of Sydney, NSW 2006, Australia; Centre for Cancer Research, Westmead Institute for Medical Research, The University of Sydney, NSW 2006, Australia
| | - Anne E Cust
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia; Melanoma Institute Australia, The University of Sydney, NSW 2006, Australia
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11
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Khan SR, Whiteman DC, Kimlin MG, Janda M, Clarke MW, Lucas RM, Neale RE. Effect of solar ultraviolet radiation exposure on serum 25(OH)D concentration: a pilot randomised controlled trial. Photochem Photobiol Sci 2018; 17:570-577. [PMID: 29619453 DOI: 10.1039/c7pp00378a] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Sunlight generates vitamin D, but there are scant human data from randomised trials on which to base health policy advice about how much sun exposure is necessary to change 25(OH)D concentrations. The purpose of the study was to evaluate the feasibility of using solar ultraviolet (UV) radiation exposure to generate a change in 25(OH)D concentration in a randomised controlled trial (RCT). The intervention tested in this RCT was supervised exposure to one standard erythemal dose (SED; 100 J m-2) of solar UV radiation three days per week for three weeks with approximately 35% of the body surface area not covered by clothing. Thirty-six fair-skinned (skin type II and III) indoor workers from Brisbane, Australia were randomised into either the intervention group (n = 16) or the control group (n = 20); the latter did not receive any supervised sun exposure. We asked both groups to use sunscreen and to minimise time outdoors during the study period. We collected blood samples at baseline, once per week during the three week intervention period, and four weeks after the intervention finished. The cumulative UV radiation exposure over the intervention period measured using polysulphone badges was higher in the intervention group than in the control group (median 8 vs. 4 SEDs, p = 0.14). After three weeks, the mean serum 25(OH)D concentration increased from 60 to 65 nmol l-1 in the intervention group and from 55 to 57 nmol l-1 in the control group. After adjustment for baseline 25(OH)D, the mean change per week during the intervention phase was non-significantly higher in the intervention than in the control group (0.7 vs. 0.3; p = 0.35). This difference was not sustained during the follow-up period. Large field trials are needed to inform policy about how much natural sun exposure is required to raise 25(OH)D concentrations. This pilot identified key issues that need to be considered in the design of such a trial.
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Affiliation(s)
- Shanchita R Khan
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia and Population Health Department, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia.
| | - David C Whiteman
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia.
| | - Michael G Kimlin
- Health Research Institute, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Monika Janda
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia and Centre for Health Services Research, The University of Queensland, Woolloongabba, QLD, Australia
| | - Michael W Clarke
- Metabolomics Australia, Centre for Microscopy, Characterisation and Analysis, The University of Western Australia, Perth, WA, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, ACT, Australia and Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA, Australia
| | - Rachel E Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia.
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12
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Yang CH, Albietz J, Harkin DG, Kimlin MG, Schmid KL. Impact of oral vitamin D supplementation on the ocular surface in people with dry eye and/or low serum vitamin D. Cont Lens Anterior Eye 2017; 41:69-76. [PMID: 28919183 DOI: 10.1016/j.clae.2017.09.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/21/2017] [Accepted: 09/08/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE To determine the possible association between serum vitamin D levels and dry eye symptoms, and the impact of an oral vitamin D supplement. METHODS Three linked studies were performed. (i) 29 older adult participants, (ii) 29 dry eyed participants, and (iii) 2-month vitamin D supplementation for 32 dry eyed/low serum vitamin D levelled participants. All participants were assessed by the Ocular Surface Diseases Index (OSDI) to determine dry eye symptoms, and the phenol red thread test (PRT) and/or Schirmer's tear test, tear meniscus height, non-invasive tear break up time, grading ocular surface redness and fluorescein staining of the cornea to detect the tear quality and ocular surface conditions. Blood samples were collected for serum vitamin D analysis and interleukin-6 (IL-6) levels. RESULTS Among older adult participants, vitamin D levels were negatively correlated with dry eye symptoms, the severity of dry eye, and associated with tired eye symptom. Vitamin D levels of people with dry eye diagnosis were not correlated with OSDI scores and IL-6 levels; while IL-6 levels showed correlation with tear production. In supplement study, vitamin D levels increased by 29mol/l, while dry eye symptoms and grading of corneal staining appeared significant reductions. No significant changes in IL-6 levels. CONCLUSIONS Low vitamin D levels (<50nmol/l) were associated with dry eye symptoms in older individuals but not those diagnosed with dry eye. Vitamin D supplement increased the vitamin D levels, and improved dry eye symptoms, the tear quality and ocular surface conditions.
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Affiliation(s)
- Chih-Huang Yang
- School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia; Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Julie Albietz
- School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia; Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Damien G Harkin
- Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia; Queensland Eye Institute, Brisbane, Queensland, Australia
| | - Michael G Kimlin
- Health Research Institute, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Katrina L Schmid
- School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia; Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; Queensland Eye Institute, Brisbane, Queensland, Australia.
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13
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Messa P, Regalia A, Alfieri CM. Nutritional Vitamin D in Renal Transplant Patients: Speculations and Reality. Nutrients 2017; 9:nu9060550. [PMID: 28554998 PMCID: PMC5490529 DOI: 10.3390/nu9060550] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 05/15/2017] [Accepted: 05/22/2017] [Indexed: 12/14/2022] Open
Abstract
Reduced levels of nutritional vitamin D are commonly observed in most chronic kidney disease (CKD) patients and particularly in patients who have received a kidney transplant (KTx). In the complex clinical scenario characterizing the recipients of a renal graft, nutritional vitamin D deficiency has been put in relation not only to the changes of mineral and bone metabolism (MBM) after KTx, but also to most of the medical complications which burden KTx patients. In fact, referring to its alleged pleiotropic (non-MBM related) activities, vitamin D has been claimed to play some role in the occurrence of cardiovascular, metabolic, immunologic, neoplastic and infectious complications commonly observed in KTx recipients. Furthermore, low nutritional vitamin D levels have also been connected with graft dysfunction occurrence and progression. In this review, we will discuss the purported and the demonstrated effects of native vitamin D deficiency/insufficiency in most of the above mentioned fields, dealing separately with the MBM-related and the pleiotropic effects.
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Affiliation(s)
- Piergiorgio Messa
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano 20122, Italy.
- via Festa del Perdono, Università degli Studi di Milano, Milano 20122, Italy.
| | - Anna Regalia
- via Festa del Perdono, Università degli Studi di Milano, Milano 20122, Italy.
| | - Carlo Maria Alfieri
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano 20122, Italy.
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14
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Brouwer-Brolsma EM, Vaes AMM, van der Zwaluw NL, van Wijngaarden JP, Swart KMA, Ham AC, van Dijk SC, Enneman AW, Sohl E, van Schoor NM, van der Velde N, Uitterlinden AG, Lips P, Feskens EJM, Dhonukshe-Rutten RAM, de Groot LCPGM. Relative importance of summer sun exposure, vitamin D intake, and genes to vitamin D status in Dutch older adults: The B-PROOF study. J Steroid Biochem Mol Biol 2016; 164:168-176. [PMID: 26275945 DOI: 10.1016/j.jsbmb.2015.08.008] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Revised: 08/02/2015] [Accepted: 08/10/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND/OBJECTIVES The prevalence of vitamin D deficiency among seniors is high. Whereas sun exposure, vitamin D intake, genes, demographics, and lifestyle have been identified as being important determinants of vitamin D status, the impact of these factors is expected to differ across populations. To improve current prevention and treatment strategies, this study aimed to explore the main determinants of vitamin D status and its relative importance in a population of community-dwelling Dutch older adults. METHODS/SUBJECTS Serum 25-hydroxyvitamin D (25(OH)D) was measured in 2857 adults aged ≥65 years. Sun exposure was assessed with a structured questionnaire (n=1012), vitamin D intake using a Food Frequency Questionnaire (n=596), and data on genetic variation that may affect 25(OH)D status was obtained for 4 genes, DHCR7 (rs12785878), CYP2R1 (rs10741657), GC (rs2282679), and CYP24A1 (rs6013897) (n=2530). RESULTS Serum 25(OH)D concentrations <50nmol/L were observed in 45% of the population; only 6% of these participants used vitamin D supplements. Sun exposure (being outside daily during summer: 66±25nmol/L vs not being outside daily during summer: 58±27nmol/L, P=0.02) and vitamin D intake (per unit μg/day during winter/spring: 3.1±0.75nmol/L, P<0.0001) were associated with higher 25(OH)D concentrations. Major allele carriers of SNPs related to DHCR7, CYP24A1, and GC, as well as CYP2R1 minor allele carriers had the highest 25(OH)D concentrations. Together, sun (R2=0.29), vitamin D intake (R2=0.24), and genes (R2=0.28) explained 35% (R2=0.35) of the variation in 25(OH)D concentrations during summer/autumn period, when adjusted for age, sex, BMI, education, alcohol consumption, smoking, physical activity, and self-rated health status (n=185). CONCLUSION The investigated determinants explained 35% of 25(OH)D status. Of the three main determinants under study, sun exposure still appeared to be an important determinant of serum 25(OH)D in older individuals, closely followed by genes, and vitamin D intake. Given the low frequency of vitamin D supplement use in this population, promoting supplement use may be an inexpensive, easy, and effective strategy to fight vitamin D deficiency.
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Affiliation(s)
- Elske M Brouwer-Brolsma
- Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands.
| | - Anouk M M Vaes
- Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands
| | - Nikita L van der Zwaluw
- Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands
| | - Janneke P van Wijngaarden
- Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands
| | - Karin M A Swart
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Annelies C Ham
- Department of Internal Medicine, Erasmus University Medical Centre, P.O. Box 2040, 3000CA Rotterdam, the Netherlands
| | - Suzanne C van Dijk
- Department of Internal Medicine, Erasmus University Medical Centre, P.O. Box 2040, 3000CA Rotterdam, the Netherlands
| | - Anke W Enneman
- Department of Internal Medicine, Erasmus University Medical Centre, P.O. Box 2040, 3000CA Rotterdam, the Netherlands
| | - Evelien Sohl
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Natasja M van Schoor
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Nathalie van der Velde
- Department of Internal Medicine, Erasmus University Medical Centre, P.O. Box 2040, 3000CA Rotterdam, the Netherlands; Department of Internal Medicine, Section of Geriatrics, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Andre G Uitterlinden
- Department of Internal Medicine, Erasmus University Medical Centre, P.O. Box 2040, 3000CA Rotterdam, the Netherlands
| | - Paul Lips
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands; Department of Internal Medicine, Endocrine Section, VU University Medical Center, P.O.Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Edith J M Feskens
- Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands
| | | | - Lisette C P G M de Groot
- Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands
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15
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Smit AK, Espinoza D, Newson AJ, Morton RL, Fenton G, Freeman L, Dunlop K, Butow PN, Law MH, Kimlin MG, Keogh LA, Dobbinson SJ, Kirk J, Kanetsky PA, Mann GJ, Cust AE. A Pilot Randomized Controlled Trial of the Feasibility, Acceptability, and Impact of Giving Information on Personalized Genomic Risk of Melanoma to the Public. Cancer Epidemiol Biomarkers Prev 2016; 26:212-221. [PMID: 27702805 DOI: 10.1158/1055-9965.epi-16-0395] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 09/15/2016] [Accepted: 09/24/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Communication of personalized melanoma genomic risk information may improve melanoma prevention behaviors. METHODS We evaluated the feasibility and acceptability of communicating personalized genomic risk of melanoma to the public and its preliminary impact on behaviors and psychosocial outcomes. One hundred eighteen people aged 22 to 69 years provided a saliva sample and were randomized to the control (nonpersonalized educational materials) or intervention (personalized booklet presenting melanoma genomic risk as absolute and relative risks and a risk category based on variants in 21 genes, telephone-based genetic counseling, and nonpersonalized educational materials). Intention-to-treat analyses overall and by-risk category were conducted using ANCOVA adjusted for baseline values. RESULTS Consent to participate was 41%, 99% were successfully genotyped, and 92% completed 3-month follow-up. Intervention participants reported high satisfaction with the personalized booklet (mean = 8.6, SD = 1.6; on a 0-10 scale) and genetic counseling (mean = 8.1, SD = 2.2). No significant behavioral effects at 3-month follow-up were identified between intervention and control groups overall: objectively measured standard erythemal doses per day [-16%; 95% confidence interval (CI), -43% to 24%] and sun protection index (0.05; 95% CI, -0.07 to 0.18). There was increased confidence identifying melanoma at 3 months (0.40; 95% CI, 0.10-0.69). Stratified by risk category, effect sizes for intentional tanning and some individual sun protection items appeared stronger for the average-risk group. There were no appreciable group differences in skin cancer-related worry or psychologic distress. CONCLUSIONS Our results demonstrate feasibility and acceptability of providing personalized genomic risk of melanoma to the public. IMPACT Genomic risk information has potential as a melanoma prevention strategy. Cancer Epidemiol Biomarkers Prev; 26(2); 212-21. ©2016 AACR.
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Affiliation(s)
- Amelia K Smit
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Australia
| | - David Espinoza
- NHMRC Clinical Trials Centre, The University of Sydney, Australia
| | - Ainsley J Newson
- Centre for Values, Ethics and the Law in Medicine, Sydney School of Public Health, The University of Sydney, Australia
| | - Rachael L Morton
- NHMRC Clinical Trials Centre, The University of Sydney, Australia
| | - Georgina Fenton
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Australia.,The Centre for Genetics Education, NSW Health, Sydney, Australia
| | - Lucinda Freeman
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Australia.,The Centre for Genetics Education, NSW Health, Sydney, Australia
| | - Kate Dunlop
- The Centre for Genetics Education, NSW Health, Sydney, Australia
| | - Phyllis N Butow
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, The University of Sydney, Australia
| | - Matthew H Law
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Michael G Kimlin
- The University of the Sunshine Coast and Cancer Council Queensland, Brisbane, Australia
| | - Louise A Keogh
- Melbourne School of Population and Global Health, The University of Melbourne, Australia
| | | | - Judy Kirk
- Westmead Clinical School, and Westmead Institute for Medical Research, Sydney Medical School, The University of Sydney, Australia
| | - Peter A Kanetsky
- Cancer Epidemiology Program, Moffitt Cancer Center, Tampa, Florida
| | - Graham J Mann
- Centre for Cancer Research, Westmead Institute for Medical Research, The University of Sydney, Australia.,Melanoma Institute Australia, The University of Sydney, Australia
| | - Anne E Cust
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Australia. .,Melanoma Institute Australia, The University of Sydney, Australia
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16
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King L, Dear K, Harrison SL, van der Mei I, Brodie AM, Kimlin MG, Lucas RM. Investigating the patterns and determinants of seasonal variation in vitamin D status in Australian adults: the Seasonal D Cohort Study. BMC Public Health 2016; 16:892. [PMID: 27565723 PMCID: PMC5002142 DOI: 10.1186/s12889-016-3582-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 08/24/2016] [Indexed: 12/11/2022] Open
Abstract
Background Vitamin D status generally varies seasonally with changing solar UVB radiation, time in the sun, amount of skin exposed, and, possibly, diet. The Seasonal D Study was designed to quantify the amplitude and phase of seasonal variation in the serum concentration of 25-hydroxyvitamin D, (25OH)D)) and identify the determinants of the amplitude and phase and those of inter-individual variability in seasonal pattern. Methods The Seasonal D Study collected data 2-monthly for 12 months, including demographics, personal sun exposure using a diary and polysulphone dosimeters over 7 days, and blood for serum 25(OH)D concentration. The study recruited 333 adults aged 18–79 years living in Canberra (35°S, n = 168) and Brisbane (27°South, n = 165), Australia. Discussion We report the study design and cohort description for the Seasonal D Study. The study has collected a wealth of data to examine inter- and intra-individual seasonal variation in vitamin D status and serum 25(OH)D levels in Australian adults. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3582-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Laura King
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | | | - Simone L Harrison
- College of Public Health, Medical & Veterinary Sciences, James Cook, University, Townsville, Australia
| | - Ingrid van der Mei
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia
| | - Alison M Brodie
- Health Research Institute, University of the Sunshine Coast, Sippy Downs, Australia.,Queensland University of Technology, Brisbane, Australia
| | - Michael G Kimlin
- Health Research Institute, University of the Sunshine Coast, Sippy Downs, Australia.,Queensland University of Technology, Brisbane, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia.
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17
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Wainwright L, Parisi A, Downs N. Dual calibrated dosimeter for simultaneous measurements of erythemal and vitamin D effective solar ultraviolet radiation. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2016; 157:15-21. [DOI: 10.1016/j.jphotobiol.2016.02.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 01/07/2016] [Accepted: 02/01/2016] [Indexed: 12/13/2022]
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18
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Djaja N, Janda M, Lucas RM, Harrison SL, van der Mei I, Ebeling PR, Neale RE, Whiteman DC, Nowak M, Kimlin MG. Self-Reported Changes in Sun-Protection Behaviors at Different Latitudes in Australia. Photochem Photobiol 2016; 92:495-502. [PMID: 26914695 DOI: 10.1111/php.12582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 12/03/2015] [Indexed: 11/30/2022]
Abstract
Sun exposure is the most important source of vitamin D, but is also a risk factor for skin cancer. This study investigated attitudes toward vitamin D, and changes in sun-exposure behavior due to concern about adequate vitamin D. Participants (n = 1002) were recruited from four regions of Australia and completed self- and interviewer-administered surveys. Chi-square tests were used to assess associations between participants' latitude of residence, vitamin D-related attitudes and changes in sun-exposure behaviors during the last summer. Multivariate logistic regression analyses were used to model the association between attitudes and behaviors. Overall, people who worried about their vitamin D status were more likely to have altered sun protection and spent more time in the sun people not concerned about vitamin D. Concern about vitamin D was also more common with increasing latitude. Use of novel item response theory analysis highlighted the potential impact of self-reported behavior change on skin cancer predisposition due concern to vitamin. This cross-sectional study shows that the strongest determinants of self-reported sun-protection behavior changes due to concerns about vitamin D were attitudes and location, with people at higher latitudes worrying more.
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Affiliation(s)
- Ngadiman Djaja
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Qld, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.,National Health and Medical Research Council Centre for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia
| | - Monika Janda
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Qld, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.,National Health and Medical Research Council Centre for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia
| | - Robyn M Lucas
- National Health and Medical Research Council Centre for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.,National Centre for Epidemiology and Research School of Population Health, The Australian National University, Canberra, ACT, Australia.,Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Simone L Harrison
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.,National Health and Medical Research Council Centre for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.,JCU Skin Cancer Research Group, Division of Tropical Health and Medicine, College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, Qld, Australia.,Anton Breinl Centre for Health Systems Strengthening, Australian Institute of Tropical Health and Medicine (AITHM), James Cook University, Townsville, Qld, Australia
| | - Ingrid van der Mei
- National Health and Medical Research Council Centre for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.,Menzies Institute for Medical Research, Hobart, Tas., Australia
| | - Peter R Ebeling
- National Health and Medical Research Council Centre for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.,School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia
| | - Rachel E Neale
- National Health and Medical Research Council Centre for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.,QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia
| | - David C Whiteman
- National Health and Medical Research Council Centre for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.,QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia
| | - Madeleine Nowak
- JCU Skin Cancer Research Group, Division of Tropical Health and Medicine, College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, Qld, Australia.,Anton Breinl Centre for Health Systems Strengthening, Australian Institute of Tropical Health and Medicine (AITHM), James Cook University, Townsville, Qld, Australia
| | - Michael G Kimlin
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Qld, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.,National Health and Medical Research Council Centre for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia
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19
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Xiang F, Harrison S, Nowak M, Kimlin M, Van der Mei I, Neale RE, Sinclair C, Lucas RM. Weekend personal ultraviolet radiation exposure in four cities in Australia: Influence of temperature, humidity and ambient ultraviolet radiation. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2015; 143:74-81. [DOI: 10.1016/j.jphotobiol.2014.12.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 10/22/2014] [Accepted: 12/27/2014] [Indexed: 01/04/2023]
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20
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Guo S, Gies P, King K, Lucas RM. Sun Exposure and Vitamin D Status as Northeast Asian Migrants Become Acculturated to Life in Australia. Photochem Photobiol 2014; 90:1455-61. [DOI: 10.1111/php.12349] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 09/13/2014] [Indexed: 12/11/2022]
Affiliation(s)
- Shuyu Guo
- National Centre for Epidemiology and Population Health; Research School of Population Health; The Australian National University; Canberra ACT Australia
| | - Peter Gies
- Australian Radiation Protection and Nuclear Safety Agency; Melbourne VIC Australia
| | - Kerryn King
- Australian Radiation Protection and Nuclear Safety Agency; Melbourne VIC Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health; Research School of Population Health; The Australian National University; Canberra ACT Australia
- Telethon Kids Institute; University of Western Australia; Perth WA Australia
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21
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Hanna K, Fassett RG, Gill E, Healy H, Kimlin M, Ross L, Ash S. Serum 25-hydroxy vitamin D concentrations are more deficient/insufficient in peritoneal dialysis than haemodialysis patients in a sunny climate. J Hum Nutr Diet 2014; 28:209-18. [PMID: 24720834 DOI: 10.1111/jhn.12234] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Research has identified associations between serum 25(OH)D and a range of clinical outcomes in chronic kidney disease and wider populations. The present study aimed to investigate vitamin D deficiency/insufficiency in dialysis patients and the relationship with vitamin D intake and sun exposure. METHODS A cross-sectional study was used. Participants included 30 peritoneal dialysis (PD) (43.3% male; 56.87 ± 16.16 years) and 26 haemodialysis (HD) (80.8% male; 63.58 ± 15.09 years) patients attending a department of renal medicine. Explanatory variables were usual vitamin D intake from diet/supplements (IU day(-1) ) and sun exposure (min day(-1) ). Vitamin D intake, sun exposure and ethnic background were assessed by questionnaire. Weight, malnutrition status and routine biochemistry were also assessed. Data were collected during usual department visits. The main outcome measure was serum 25(OH)D (nm). RESULTS Prevalence of inadequate/insufficient vitamin D intake differed between dialysis modality, with 31% and 43% found to be insufficient (<50 nm) and 4% and 33% found to be deficient (<25 nm) in HD and PD patients, respectively (P < 0.001). In HD patients, there was a correlation between diet and supplemental vitamin D intake and 25(OH)D (ρ = 0.84, P < 0.001) and average sun exposure and 25(OH)D (ρ = 0.50, P < 0.02). There were no associations in PD patients. The results remained significant for vitamin D intake after multiple regression, adjusting for age, gender and sun exposure. CONCLUSIONS The results highlight a strong association between vitamin D intake and 25(OH)D in HD but not PD patients, with implications for replacement recommendations. The findings indicate that, even in a sunny climate, many dialysis patients are vitamin D deficient, highlighting the need for exploration of determinants and consequences.
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Affiliation(s)
- K Hanna
- Queensland University of Technology, Brisbane, QLD, Australia
| | - R G Fassett
- Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.,The University of Queensland, Brisbane, QLD, Australia
| | - E Gill
- Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - H Healy
- Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - M Kimlin
- Queensland University of Technology, Brisbane, QLD, Australia
| | - L Ross
- Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - S Ash
- Queensland University of Technology, Brisbane, QLD, Australia
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22
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Kimlin MG, Lucas RM, Harrison SL, van der Mei I, Armstrong BK, Whiteman DC, Kricker A, Nowak M, Brodie AM, Sun J. The contributions of solar ultraviolet radiation exposure and other determinants to serum 25-hydroxyvitamin D concentrations in Australian adults: the AusD Study. Am J Epidemiol 2014; 179:864-74. [PMID: 24573539 DOI: 10.1093/aje/kwt446] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The Quantitative Assessment of Solar UV [ultraviolet] Exposure for Vitamin D Synthesis in Australian Adults (AusD) Study aimed to better define the relationship between sun exposure and serum 25-hydroxyvitamin D (25(OH)D) concentration. Cross-sectional data were collected between May 2009 and December 2010 from 1,002 participants aged 18-75 years in 4 Australian sites spanning 24° of latitude. Participants completed the following: 1) questionnaires on sun exposure, dietary vitamin D intake, and vitamin D supplementation; 2) 10 days of personal ultraviolet radiation dosimetry; 3) a sun exposure and physical activity diary; and 4) clinical measurements and blood collection for 25(OH)D determination. Our multiple regression model described 40% of the variance in 25(OH)D concentration; modifiable behavioral factors contributed 52% of the explained variance, and environmental and demographic or constitutional variables contributed 38% and 10%, respectively. The amount of skin exposed was the single strongest contributor to the explained variance (27%), followed by location (20%), season (17%), personal ultraviolet radiation exposure (8%), vitamin D supplementation (7%), body mass index (weight (kg)/height (m)(2)) (4%), and physical activity (4%). Modifiable behavioral factors strongly influence serum 25(OH)D concentrations in Australian adults. In addition, latitude was a strong determinant of the relative contribution of different behavioral factors.
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23
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Sun J, Lucas RM, Harrison SL, van der Mei I, Whiteman DC, Mason R, Nowak M, Brodie AM, Kimlin MG. Measuring Exposure to Solar Ultraviolet Radiation Using a Dosimetric Technique: Understanding Participant Compliance Issues. Photochem Photobiol 2014; 90:919-24. [DOI: 10.1111/php.12265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 02/20/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Jiandong Sun
- AusSun Research Laboratory; School of Public Health; Institute of Health and Biomedical Innovation; Queensland University of Technology; Brisbane QLD Australia
- National Health and Medical Research Council Centre for Research Excellence in Sun and Health; School of Public Health; Institute of Health and Biomedical Innovation; Queensland University of Technology; Brisbane QLD Australia
| | - Robyn M. Lucas
- National Health and Medical Research Council Centre for Research Excellence in Sun and Health; School of Public Health; Institute of Health and Biomedical Innovation; Queensland University of Technology; Brisbane QLD Australia
- National Centre for Epidemiology and Population Health; College of Medicine, Biology and Environment; Australian National University; Canberra ACT Australia
| | - Simone L. Harrison
- AusSun Research Laboratory; School of Public Health; Institute of Health and Biomedical Innovation; Queensland University of Technology; Brisbane QLD Australia
- Faculty of Medicine; Health and Molecular Sciences; School of Public Health, Tropical Medicine and Rehabilitation Sciences; James Cook University; Townsville QLD Australia
| | | | - David C. Whiteman
- National Health and Medical Research Council Centre for Research Excellence in Sun and Health; School of Public Health; Institute of Health and Biomedical Innovation; Queensland University of Technology; Brisbane QLD Australia
- Population Health Division; QIMR Berghofer Medical Research Institute; Brisbane QLD Australia
| | - Rebecca Mason
- Sydney School of Public Health; University of Sydney; Sydney NSW Australia
| | - Madeleine Nowak
- Faculty of Medicine; Health and Molecular Sciences; School of Public Health, Tropical Medicine and Rehabilitation Sciences; James Cook University; Townsville QLD Australia
| | - Alison M. Brodie
- AusSun Research Laboratory; School of Public Health; Institute of Health and Biomedical Innovation; Queensland University of Technology; Brisbane QLD Australia
| | - Michael G. Kimlin
- AusSun Research Laboratory; School of Public Health; Institute of Health and Biomedical Innovation; Queensland University of Technology; Brisbane QLD Australia
- National Health and Medical Research Council Centre for Research Excellence in Sun and Health; School of Public Health; Institute of Health and Biomedical Innovation; Queensland University of Technology; Brisbane QLD Australia
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24
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Borradale D, Isenring E, Hacker E, Kimlin M. Exposure to solar ultraviolet radiation is associated with a decreased folate status in women of childbearing age. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2014; 131:90-5. [DOI: 10.1016/j.jphotobiol.2014.01.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 12/21/2013] [Accepted: 01/07/2014] [Indexed: 02/07/2023]
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25
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Sun J, Lucas RM, Harrison S, van der Mei I, Armstrong BK, Nowak M, Brodie A, Kimlin MG. The relationship between ambient ultraviolet radiation (UVR) and objectively measured personal UVR exposure dose is modified by season and latitude. Photochem Photobiol Sci 2014; 13:1711-8. [DOI: 10.1039/c4pp00322e] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Despite the widespread use of ambient ultraviolet radiation (UVR) as a proxy measure of personal exposure to UVR, the relationship between the two is not well-defined.
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Affiliation(s)
- J. Sun
- AusSun Research Laboratory
- School of Public Health and Social Work
- Queensland University of Technology
- Brisbane, Australia
- NHMRC Centre for Research Excellence in Sun and Health
| | - R. M. Lucas
- National Centre for Epidemiology and Population Health
- College of Medicine
- Biology and Environment
- Australian National University
- Australia
| | - S. Harrison
- JCU Skin Cancer Research Group
- School of Public Health
- Tropical Medicine & Rehabilitation Sciences
- James Cook University
- Australia
| | | | | | - M. Nowak
- JCU Skin Cancer Research Group
- School of Public Health
- Tropical Medicine & Rehabilitation Sciences
- James Cook University
- Australia
| | - A. Brodie
- AusSun Research Laboratory
- School of Public Health and Social Work
- Queensland University of Technology
- Brisbane, Australia
| | - M. G. Kimlin
- AusSun Research Laboratory
- School of Public Health and Social Work
- Queensland University of Technology
- Brisbane, Australia
- NHMRC Centre for Research Excellence in Sun and Health
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