Cyclic changes of vitamin D and PTH are primarily regulated by solar radiation: 5-year analysis of a German (50 degrees N) population.

Cutaneous vitamin D precursor production depends on UV-exposure and is ineffective in most regions above latitudes of 50 degrees in winter. We hypothesized whether the cyclic course of vitamin D levels can be modelled with sunshine duration and would affect parathyroid hormone concentrations, but not calcium in a large patient population. We investigated 13330 blood samples from 6099 in- and out patients for 25(OH)D3, 1,25(OH)2D3, PTH, and total Ca in Frankfurt, Germany over 6.5 years. Vitamin D deficiency [25(OH)D3 <10 ng/ml] was found in 12.23% and vitamin D insufficiency [25(OH)D3 <20 ng/ml] in 40.62% of all the blood samples and more frequently during winter. We observed a significant difference between men and women, children and adults, migrants and local residents. Cycling of the curve was significantly related to Julian day for 25(OH)D3 and parathyroid hormone (PTH), but not for 1,25(OH)2D3 and Ca. The peak concentration of 25(OH)D3 was found at Aug 16th and correlated well with the length of day whereas PTH is inversely related with 25(OH)D (3). Seasonal cycling of 25(OH)D3-levels correlated significantly with Julian Day and inversely with PTH. This tight feed back ensures stable Ca concentrations within narrow limits. We conclude that changes in vitamin D levels are mainly regulated by solar radiation and to a lesser degree by other factors such as nutrition.