Abstract
BackgroundVitamin D may play a protective role in many diseases. Public health messages are advocating sun avoidance to reduce skin cancer risk but the potential deleterious effects of these recommendations for vitamin D metabolism have been poorly investigated.Methodology/Principal FindingsWe investigated the association between 25-hydroxy-vitamin D (25(OH)D), skin type and ultraviolet exposure in 1414 Caucasian females in the UK. Mean age of the cohort was 47 years (18–79) and mean 25(OH)D levels were 77 nmol/L (6–289). 25(OH)D levels were strongly associated with season of sampling with higher levels in the spring and summer months (p<0.0001). Light skin types (skin type 1 and 2) have lower levels of 25(OH)D (mean 71 nmol/L) compared to darker skin types (skin type 3 and 4) (mean 82 nmol/L) after adjusting for multiple confounders (p<0.0001). The trend for increasing risk of low vitamin D with fairer skin types was highly significant despite adjustment for all confounders (p = 0.001).Conclusions/SignificanceContrary to previous studies across different ethnic backgrounds, this study within Caucasian UK females shows that fair skin types have lower levels of 25(OH)D compared to darker skin types with potential detrimental health effects. Public health campaigns advocating sun avoidance in fair skinned individuals may need to be revised in view of their risk of vitamin D deficiency.
Highlights
Sun exposure has long been associated with an increased risk of melanoma and non melanoma skin cancers as well as photoageing[1]
Public health campaigns for skin cancer prevention may need to be reviewed to be adapted to respective geographical areas in view of the variations in skin types and ambient ultraviolet exposure
Vitamin D levels were influenced by season of blood sampling (r = 0.34 p,0.0001): mean 25(OH)D level during the spring and summer months was 93 nmol/L compared to 66 nmol/L in the autumn and winter months
Summary
Sun exposure has long been associated with an increased risk of melanoma and non melanoma skin cancers as well as photoageing[1]. Recent studies have shown that higher levels of 25(OH)D, which are maintained by sun exposure, are associated with lower incidence of many common diseases; especially cancer. More recent studies have shown an association between low serum 25(OH)D levels and metabolic syndrome characterised by abdominal obesity, raised blood pressure and triglycerides with low HDL cholesterol [7]. Advice about avoiding sun exposure and the use of sunscreens for the primary prevention of skin cancer may lead to vitamin D deficiency in susceptible individuals. Public health messages are advocating sun avoidance to reduce skin cancer risk but the potential deleterious effects of these recommendations for vitamin D metabolism have been poorly investigated
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