Nadine Jager1,2, Jakob Schöpe1,3, Stefan Wagenpfeil1,3, Peter Bocionek4, Roman Saternus1,2, Thomas Vogt1,2, Jörg Reichrath5,2. 1. Center for Clinical and Experimental Photodermatology, The Saarland University Hospital, Homburg, Germany. 2. Department of Dermatology, The Saarland University Hospital, Homburg, Germany. 3. Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University, Homburg, Germany. 4. Jörg Wolff Foundation, Stuttgart, Germany. 5. Center for Clinical and Experimental Photodermatology, The Saarland University Hospital, Homburg, Germany Joerg.reichrath@uks.eu.
Abstract
BACKGROUND/AIM: To optimize public health campaigns concerning UV exposure, it is important to characterize factors that influence UV-induced cutaneous vitamin D production. This systematic review and meta-analysis investigated the impact of different individual and environmental factors including exposed body surface area (BSA), UVB dose and vitamin D status, on serum 25(OH)D concentration. MATERIALS AND METHODS: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses, and Meta-analysis of Observational studies in Epidemiology guidelines, a systematic literature search was conducted (MEDLINE; 01/1960-07/2016) investigating the impact of these factors on vitamin D status after artificial UV exposure as main outcome measure. Summary mean differences [and 95% confidence interval (CI)] were derived from random-effects meta-analysis to account for possible heterogeneity across studies. Meta-regression was conducted to account for impact of UVB dose, baseline 25(OH)D level and BSA. RESULTS: We identified 15 studies, with an estimated mean 25(OH)D rise per standard erythema dose (SED) of 0.19 nmol/l (95% CI 0.11-0.26 nmol/l). Results from meta-regression suggest a significant impact of UV dose and baseline 25(OH)D concentration on serum 25(OH)D level (p<0.01). Single UVB doses between 0.75 and 3 SED resulted in the highest rise of serum 25(OH)D per dose unit. BSA exposed had a smaller, non-proportional, not significant impact. Partial BSA exposure resulted in relatively higher rise compared to whole-body exposure (e.g. exposure of face and hands caused an 8-fold higher rise of serum 25(OH)D concentration/SED/1% BSA compared to whole-body exposure). Our findings support previous reports, estimating that the half-life of serum 25(OH)D varies depending on different factors. CONCLUSION: Our results indicate that partial BSA exposure (e.g. 10%) with moderate UV doses (e.g. 1 SED) is effective in generating or maintaining a healthy vitamin D status. However, due to limitations that include possible confounding factors such as skin type, which could not be considered, these findings should be interpreted with caution. Copyright
BACKGROUND/AIM: To optimize public health campaigns concerning UV exposure, it is important to characterize factors that influence UV-induced cutaneous vitamin D production. This systematic review and meta-analysis investigated the impact of different individual and environmental factors including exposed body surface area (BSA), UVB dose and vitamin D status, on serum 25(OH)D concentration. MATERIALS AND METHODS: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses, and Meta-analysis of Observational studies in Epidemiology guidelines, a systematic literature search was conducted (MEDLINE; 01/1960-07/2016) investigating the impact of these factors on vitamin D status after artificial UV exposure as main outcome measure. Summary mean differences [and 95% confidence interval (CI)] were derived from random-effects meta-analysis to account for possible heterogeneity across studies. Meta-regression was conducted to account for impact of UVB dose, baseline 25(OH)D level and BSA. RESULTS: We identified 15 studies, with an estimated mean 25(OH)D rise per standard erythema dose (SED) of 0.19 nmol/l (95% CI 0.11-0.26 nmol/l). Results from meta-regression suggest a significant impact of UV dose and baseline 25(OH)D concentration on serum 25(OH)D level (p<0.01). Single UVB doses between 0.75 and 3 SED resulted in the highest rise of serum 25(OH)D per dose unit. BSA exposed had a smaller, non-proportional, not significant impact. Partial BSA exposure resulted in relatively higher rise compared to whole-body exposure (e.g. exposure of face and hands caused an 8-fold higher rise of serum 25(OH)D concentration/SED/1% BSA compared to whole-body exposure). Our findings support previous reports, estimating that the half-life of serum 25(OH)D varies depending on different factors. CONCLUSION: Our results indicate that partial BSA exposure (e.g. 10%) with moderate UV doses (e.g. 1 SED) is effective in generating or maintaining a healthy vitamin D status. However, due to limitations that include possible confounding factors such as skin type, which could not be considered, these findings should be interpreted with caution. Copyright
Authors: Stefan Pilz; Winfried März; Kevin D Cashman; Mairead E Kiely; Susan J Whiting; Michael F Holick; William B Grant; Pawel Pludowski; Mickael Hiligsmann; Christian Trummer; Verena Schwetz; Elisabeth Lerchbaum; Marlene Pandis; Andreas Tomaschitz; Martin R Grübler; Martin Gaksch; Nicolas Verheyen; Bruce W Hollis; Lars Rejnmark; Spyridon N Karras; Andreas Hahn; Heike A Bischoff-Ferrari; Jörg Reichrath; Rolf Jorde; Ibrahim Elmadfa; Reinhold Vieth; Robert Scragg; Mona S Calvo; Natasja M van Schoor; Roger Bouillon; Paul Lips; Suvi T Itkonen; Adrian R Martineau; Christel Lamberg-Allardt; Armin Zittermann Journal: Front Endocrinol (Lausanne) Date: 2018-07-17 Impact factor: 5.555
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