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Prevalence and predictors of low vitamin D status in patients referred to a tertiary photodiagnostic service: a retrospective study
Author(s) -
Reid Suzanne M.,
Robinson Mark,
Kerr Alastair C.,
Ibbotson Sally Helen
Publication year - 2012
Publication title -
photodermatology, photoimmunology and photomedicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.736
H-Index - 60
eISSN - 1600-0781
pISSN - 0905-4383
DOI - 10.1111/j.1600-0781.2011.00644.x
Subject(s) - tertiary level , retrospective cohort study , tertiary care , medicine , service (business) , environmental health , psychology , business , marketing , mathematics education
Summary Background/Purpose Low vitamin D levels have been associated with adverse effects on health. The primary source of vitamin D is cutaneous production during sunlight exposure. S un avoidance can restrict vitamin D photosynthesis and is common practice amongst patients with photosensitivity. Few studies have examined vitamin D status in this population, particularly those in northern latitudes. The purpose of this study was therefore to investigate the prevalence and possible predictors of low vitamin D status in patients referred to a tertiary photodiagnostic service. Methods A case note review of 165 patients who attended the N ational P hotodiagnostic S ervice for assessment at the P hotobiology U nit in D undee, S cotland (latitude 56° N ) over 1 year was conducted. Clinical information and serum 25‐hydroxyvitamin D (25( OH ) D ) concentration were documented. Multivariate analyses were used to identify predictors of vitamin D status. Results Mean 25( OH ) D concentration was 41.9 nmol/ L [standard deviation ( SD ) 22.0]. Forty percent of patients had insufficient vitamin D levels [25( OH ) D 25–49 nmol/ L ] and 25% were vitamin D deficient [25( OH ) D < 25 nmol/ L ]. Blood collection in winter was the strongest predictor of low 25( OH ) D status ( P < 0.001); strict photoprotection ( P = 0.04), onset of symptoms within an hour of sunlight exposure ( P = 0.01) and abnormal monochromator phototesting responses ( P = 0.009) also predicted low vitamin D levels. Supplement use was associated with higher vitamin D levels ( P < 0.001), even amongst patients who strictly avoided sunlight ( P = 0.03). Conclusions Patients with photosensitivity who live in northern latitudes are at high risk of low vitamin D levels, particularly in winter and spring. Increased awareness of this risk is crucial to ensure preventative strategies, such as supplementation, are implemented.