Low Sun Exposure Research Articles

Performance Analysis and Comparison of Different Photovoltaic Modules Technologies under Different Climatic Conditions in Casablanca

The main goal of this work is to study the performance of silicon-based photovoltaic modules of different technologies (Monocrystalline (c-si), Polycrystalline (p-si) and Amorphous (a-si)) installed on rooftop of the Ben m’sik faculty at Hassan II university, Casablanca, Morocco (Latitude 33°36”N, Longitude 7°36”W). This study is based on daily measurements under various climatic conditions (clear, cloudy and rainy). In order to improve the performance evaluation, the real-time measurements were taken for every five minutes of different climatic parameters (solar irradiation, ambient temperature, module temperature, wind speed and direction) and electrical parameters (power, current and voltage). In fact, we studied the PV array efficiency, the inverter efficiency and the system efficiency. In addition, we performed an evaluation to the PV array, reference and final yields and the performance ratio (PR). The results show maximum values for module efficiency, final efficiency and system efficiency on a clear day for all three technologies due to high irradiation. The maximum values of PR are 72.10%, 91.53% and 86.20%, are obtained on a cloudy day, this is due to the low temperature and the high wind speed. Minimum values of PR, module efficiency, reference efficiency and final efficiency on a rainy day are due to the low sun exposure and the rain which affect the generated energy and stability of PV systems.

Mitochondrial DNA deletion percentage in sun exposed and non sun exposed skin

The percentages of mitochondrial genomes carrying the mtDNA3895 and the mtDNA4977 (common) deletion were quantified in sun exposed and non sun exposed skin biopsies, for five cohorts of patients varying either in sun exposure profile, age or skin cancer status.Non-melanoma skin cancer diagnoses are rising in Ireland and worldwide [12] but most risk prediction is based on subjective visual estimations of sun exposure history. A quantitative objective test for pre-neoplastic markers may result in better adherence to sun protective behaviours. Mitochondrial DNA (mtDNA) is known to be subject to the loss of a significant proportion of specific sections of genetic code due to exposure to ultraviolet light in sunlight. Although one such deletion has been deemed more sensitive, another, called the mtDNA4977 or common deletion, has proved to be a more useful indicator of possible risk in this study.Quantitative molecular analysis was carried out to determine the percentage of genomes carrying the deletion using non sun exposed and sun exposed skin biopsies in cohorts of patients with high or low sun exposure profiles and two high exposure groups undergoing treatment for NMSC.Results indicate that mtDNA deletions correlate to sun exposure; in groups with high sun exposure habits a significant increase in deletion number in exposed over non sun exposed skin occurred. An increase in deletion percentage was also seen in older cohorts compared to the younger group.The mtDNA3895 deletion was detected in small amounts in exposed skin of many patients, the mtDNA4977 common deletion, although present to some extent in non sun exposed skin, is suggested to be the more reliable and easily detected marker. In all cohorts except the younger group with relatively lower sun exposure, the mtDNA4977 deletion was more frequent in sun exposed skin samples compared to non-sun exposed skin.

Vitamin D in relation to bone health and muscle function in young female soccer players

The present work investigated serum vitamin D (25(OH)D) status in relation to bone and muscle qualities and functions in 19 female soccer players (13–16 years) resident at northern latitude with very low sun exposure (∼32–36 h/month) during winter season (late January to early March). Serum 25(OH)D, parathyroid hormone and bone turnover markers osteocalcin (OC) and beta carboxy-terminal collagen cross-links (β-Ctx), as well as body composition and muscle performance were examined. Hormones were tested using routine laboratory methods. Fat mass, lean mass, and bone mineral density in whole body, as well as femur and lumbar spine were evaluated with dual-energy X-ray absorptiometry. Muscle performance was assessed through isokinetic knee extension and flexion, countermovement jump, and sprint running. 25(OH)D was low (50.5 ± 12.8 nmol l−1), whereas the values of bone turnover markers were markedly high (OC: 59.4 ± 18.6 µg l−1; β-Ctx: 1075 ± 408 ng l−1). All bone and muscle measurements were normal or above normal. 25(OH)D was not significantly correlated with most of the parameters of bone and muscle quality or function, except the knee extension time to peak torque (r = −0.50, p = .03). In conclusion, the level of vitamin D is markedly low in adolescent female soccer players during the winter in Sweden. However, vitamin D levels did not significantly correlate with measures of bone and muscle except a moderate correlation in time to peak torque in the knee extensors. The practical implication of low vitamin D levels in young growing female athletes remains unclear.

IMPACT OF DEFICIENT NUTRITION IN BONE MASS AFTER BARIATRIC SURGERY.

Background: Essential nutrients are considered for the prevention of the bone loss that occurs after bariatric surgery. Aim: Evaluate nutrients involved in bone metabolism, and relate to serum concentrations of calcium, vitamin D, and parathyroid hormone, and the use of supplements and sun exposure on the bone mass of patients who had undergone gastric bypass surgery. Methods: An observational study, with patients who had undergone the surgery 12 or more months previously, operated group (OG), compared to a control group (CG). Results: Were included 56 in OG and 27 in the CG. The mean age was 36.4±8.5 years. The individuals in the OG, compared to CG, consumed inadequate amounts of protein and daily calcium. The OG had a higher prevalence of low sun exposure, lower levels of 25OH Vitamin D (21.3±10.9 vs. 32.1±11.8 ng/dl), and increased serum levels of parathyroid hormone (68.1±32.9 vs. 39.9±11.9 pg/ml, p<0.001). Secondary hyperparathyroidism was present only in the OG (41.7%). The mean lumbar spine bone mineral density was lower in the OG. Four individuals from the OG had low bone mineral density for chronological age, and no one from the CG. Conclusion: The dietary components that affect bone mass in patients undergoing bariatric surgery were inadequate. The supplementation was insufficient and the sun exposure was low. These changes were accompanied by secondary hyperparathyroidism and a high prevalence of low bone mass in lumbar spine in these subjects.

Quick and Easy Screening for Vitamin D Insufficiency in Adults: A Scoring System to Be Implemented in Daily Clinical Practice.

Vitamin D is essential regarding several health outcomes. Prevention of insufficiency (25-hydroxyvitamin D concentration ≤20 ng/mL) generally entails blood testing and/or supplementation, strategies that should target at-risk individuals because blood testing is costly, and unwarranted supplementation could result in vitamin D overload with unknown long-term consequences. Our objective was to develop a simple score (Vitamin D Insufficiency Prediction score, VDIP) for identifying adults at risk of vitamin D insufficiency. Subjects were 1557 non-vitamin D-supplemented middle-aged adults from the SU.VI.MAX cohort. Scoring points corresponded to the rounded odds ratio for each individual-level characteristic associated with vitamin D insufficiency in a multivariable logistic regression model. Receiver operating characteristic curve (area under curve), sensitivity, specificity, and positive and negative predictive values were computed. External validation was performed in an independent cohort (NutriNet-Santé, N = 781). For female sex, overweight, low physical activity, winter season, moderate sun exposure, and very fair or dark skin 1.5 points were attributed; 2 points for latitude ≥48°N and spring season; 2.5 points for obesity and late winter; 3 points for low sun exposure. Points were then summed up for each participant. The VDIP score had an AUC = 0.70 ± 0.01 (validation: 0.67 ± 0.02). With a score of 7 or more, 70% of the participants were vitamin D-insufficient (80% in those with a score ≥9), sensitivity/specificity were 0.67/0.63, and positive and negative predictive values were 0.70/0.59. The VDIP score performed well in identifying middle-aged adults at risk of vitamin D insufficiency (score ≥7, moderate risk; score≥9, high risk), using only simple individual-level characteristics easily assessable in day-to-day clinical practice. Implementation of this simple and costless score could thus obviate unwarranted supplementation and/or blood testing.

Predictors of Serum 25-Hydroxyvitamin D Concentrations among a Sample of Egyptian Schoolchildren.

Objective. To assess the level of 25-hydroxyvitamin D status among a sample of Egyptian schoolchildren and to evaluate predictors of deficiency and insufficiency. Subjects and Methods. A cross-sectional study comprising 200 prepubescent schoolchildren aged from 9 to 11 years was performed. A questionnaire including frequency of midday sun exposure, milk intake, physical activity, and level of maternal education was taken. Body mass index (BMI) was calculated; serum 25-hydroxyvitamin D [25(OH)D], serum calcium, phosphorus, and parathyroid hormone were measured. Results. Vitamin D deficiency [serum 25(OH)D < 20 ng/mL] was detected in 11.5% of subjects while its insufficiency (serum 25(OH)D is between 20 and 29.9 ng/mL) was detected in 15%. Results revealed that obesity, low physical activity, low sun exposure, and low maternal education level are significant predictors of insufficiency, though female gender, low maternal education level, and low milk intake are significant predictors of deficiency. Lower serum phosphorus and higher serum parathyroid hormone were significantly associated with both deficiency and insufficiency (p < 0.05). Conclusion. Vitamin D deficiency and insufficiency are common among schoolchildren in Egypt. Food fortification, vitamin D supplementation, and increasing maternal awareness about the importance of physical activity and exposure of their children to ultraviolet light may help to overcome this problem.

Seasonal variation of vitamin D levels in Swiss athletes

Introduction: Vitamin D deficiency is very prevalent in world population and growing evidence shows that also athletes are affected. Vitamin D deficiency causes beside bone disorders, musculoskeletal pain, muscle weakness and is associated with many other health disorders. For athletes in particular it may impair training and performance, prolong recovery and increase risk of injury. We therefore analyzed vitamin D levels in Swiss athletes focusing on prevalence according to age, gender, seasonal variations, indoor or outdoor sports, sunscreen use and vitamin D supplementation. Methods: This study was performed in a convenient sample of 655 Swiss Olympic athletes over one year. Blood samples were obtained and a questionnaire was filled in at Swiss Olympic Medical Centers or Bases during an annual routine exam. Data were then sent to the central laboratory of the Aarau hospital where they were processed and sent to us in an anonymized version. Vitamin D levels were categorized into deficiency (≤ 50 nmol/l), insufficiency (between 50 and 75 nmol/l) and adequate levels (&gt; 75 nmol/l) of 25-hydroxyvitamin D. By means of the questionnaire, we assessed age, gender, type of sport, symptoms possibly related to vitamin D deficiency during the last year, frequency of sunscreen use and vitamin D-containing medications of the athletes. Results: 13.5% of the participants (total number = 651) presented a vitamin D deficiency, 37.8% a vitamin D insufficiency so that more than half of the athletes (51.2%) had inadequate vitamin D levels. Inadequate vitamin D levels were more prevalent in younger athletes, during seasons with lower sun exposure, in indoor sports during the sun deprived seasons, in athletes without vitamines supplementation and in athletes of lower Swiss Olympic classes compared to their counterparts. Conclusions: The results of the study show that the prevalence of inadequate vitamin D levels in Swiss athletes is substantial for younger athletes (&lt; 18 years of age) and for indoor athletes during sun deprived periods of the year. However, a general vitamin supplementation containing vitamin D reduced the prevalence of vitamin D inadequacy which is especially relevant during sun deprived seasons.

The prevalence and determinants of use of vitamin D supplements among children in Alberta, Canada: a cross-sectional study.

BackgroundLimited cutaneous synthesis due to low sun exposure and inadequate dietary intake makes vitamin D supplementation a necessity for many Canadian children. Identification of the factors associated with supplement use is necessary for public health awareness campaigns, but they have not been identified previously. Therefore, the purpose of this study was to assess the prevalence and the determinants of the use of vitamin D supplements among children in the province of Alberta, Canada.MethodsIn 2014, a representative sample of grade five students (10–11 y) in Alberta (n = 2686) was surveyed. Data on dietary intake and use of vitamin D supplements were obtained using a modified Harvard Youth/Adolescent Food Frequency questionnaire. Mixed effect multiple logistic regression was employed to identify the key correlates of supplement use.ResultsUse of vitamin D supplements by children was 29.45 % although only 11.83 % took supplements daily. Children who resided in a metropolitan area (OR = 1.32; 95 % CI:1.06–1.65), were more physically active (2nd tertile: OR = 1.39; 95 % CI:1.09–1.78 and 3rd tertile: OR = 1.70; 95 % CI:1.33–2.16), or whose parents completed college (OR = 1.35; 95 % CI:1.05–1.74) were more likely to take vitamin D supplements. Prevalence of use was highest among those who had a high vitamin D diet and those with under/normal body weight status, although supplement use was not statistically associated with either dietary vitamin D intake or weight status.ConclusionsA considerable proportion of children did not take vitamin D supplements. Region of residence, physical activity level and parental education were determinants of supplement use, independent of child’s gender, household income, weight status and dietary practices. We suggest prioritizing public health efforts to support strategies to make parents aware of the importance of providing the correct dose of vitamin D supplements for their children to meet dietary recommendations.

Vitamin D Status and Its Determinants in Healthy Slovenian Pregnant Women

Background/Aims: Vitamin D deficiency is a common underdiagnosed condition. The aim of this was to analyze the status of vitamin D and its determinants in healthy Slovenian pregnant women. Methods: A total of 132 volunteer pregnant women completed a questionnaire including baseline demographics, food frequency, physical activities; anthropometrical measurements, body mass index and levels of 25-(OH)D in serum were performed during the third trimester, and dietary intakes were assessed during the 27-28th week of gestation. Results: Vitamin D deficiency was present in 14% while insufficiency was present in 41% of women. The risk for inadequacy was higher in women older than 30 years (p = 0.01), in those with less frequent outdoor physical activity (p = 0.01) and in pregnancies during the low sun exposure season (p = 0.04). Insufficiency was not significantly more frequent in less educated women, unemployed and in those living in urban area. The median value of vitamin D from habitual dietary intake was 1.5 µg/day (range 0.1-13.4) and did not influence 25-hydroxyvitamin D level (p = 0.91). Conclusions: The prevalence of vitamin D inadequacy was 55% and was dependent on age, season and outdoor physical activities. The results suggest a discrepancy between vitamin D intake through habitual diet and the reference needs.

Does fortification of staple foods improve vitamin D intakes and status of groups at risk of deficiency? A United Kingdom modeling study

More than one-fifth of the United Kingdom population has poor vitamin D status (serum 25-hydroxyvitamin D [25(OH)D] concentration <25 nmol/L), particularly individuals with low sun exposure or poor dietary intake. We identified the fortification vehicle and concentration most likely to safely increase population vitamin D intakes and vitamin D status. Wheat flour and milk were identified as primary fortification vehicles for their universal consumption in population groups most at risk of vitamin D deficiency including children aged 18-36 mo, females aged 15-49 y, and adults aged ≥65 y. With the use of data from the first 2 y (2008-2010) of the National Diet and Nutrition Survey Rolling Program, we simulated the effect of fortifying wheat flour and milk with vitamin D on United Kingdom food consumption. Empirically derived equations for the relation between vitamin D intake and the serum 25(OH)D concentration were used to estimate the population serum 25(OH)D concentration for each fortification scenario. At a simulated fortification of 10 μg vitamin D/100 g wheat flour, the proportion of at-risk groups estimated to have vitamin D intakes below United Kingdom Reference Nutrient Intakes was reduced from 93% to 50%, with no individual exceeding the United Kingdom Tolerable Upper Intake Level; the 2.5th percentile of the population winter serum 25(OH)D concentration rose from 20 to 27 nmol/L after fortification. The simulation of the fortification of wheat flour at this concentration was more effective than that of the fortification of milk (at concentrations between 0.25 and 7 mg vitamin D/100 L milk) or of the fortification of milk and flour combined. To our knowledge, this study provides new evidence that vitamin D fortification of wheat flour could be a viable option for safely improving vitamin D intakes and the status of United Kingdom population groups at risk of deficiency without increasing risk of exceeding current reference thresholds.

Population attributable fractions and joint effects of key risk factors for multiple sclerosis

Aim: We examined the combined effect of having multiple key risk factors and the interactions between the key risk factors of multiple sclerosis (MS). Methods: We performed an incident case-control study including cases with a first clinical diagnosis of central nervous system demyelination (FCD) and population-based controls. Results: Compared to those without any risk factors, those with one, two, three, and four or five risk factors had increased odds of being an FCD case of 2.12 (95% confidence interval (CI), 1.11–4.03), 4.31 (95% CI, 2.24–8.31), 7.96 (95% CI, 3.84–16.49), and 21.24 (95% CI, 5.48–82.40), respectively. Only HLA-DR15 and history of infectious mononucleosis interacted significantly on the additive scale (Synergy index, 3.78; p = 0.03). The five key risk factors jointly accounted for 63.8% (95% CI, 43.9–91.4) of FCD onset. High anti-EBNA IgG was another important contributor. Conclusions: A high proportion of FCD onset can be explained by the currently known risk factors, with HLA-DR15, ever smoking and low cumulative sun exposure explaining most. We identified a significant interaction between HLA-DR15 and history of IM in predicting an FCD of CNS demyelination, which together with previous observations suggests that this is a true interaction.

Association between 25(OH)D Level, Ultraviolet Exposure, Geographical Location, and Inflammatory Bowel Disease Activity: A Systematic Review and Meta-Analysis.

BackgroundThere is no consensus on the vitamin D levels and inflammatory bowel disease (IBD).AimTo conduct a systematic review and meta-analysis to analyze the relationship between IBD and 25(OH)D, sun exposure, and latitude, and to determine whether vitamin D deficiency affects the severity of IBD.MethodsWe searched the PubMed, EBSCO, and ClinicalTrials.gov databases to identify all studies that assessed the association between 25(OH)D, sun exposure, latitude, and IBD through November 1, 2014, without language restrictions. Studies that compared 25(OH)D levels between IBD patients and controls were selected for inclusion in the meta-analysis. We calculated pooled standardized mean differences (SMDs) and odds ratios (ORs).ResultsThirteen case-control studies investigating CD and 25(OH)D levels were included, and eight studies part of above studies also investigated the relationship between UC and 25(OH)D. Both CD patients (SMD: 0.26 nmol/L, 95% confidence interval [CI]: 0.09–0.42 nmol/L) and UC patients (SMD: 0.5 nmol/L, 95% CI: 0.15–0.85 nmol/L) had lower levels of 25(OH)D than controls. In addition, CD patients and UC patients were 1.95 times (OR, 1.95; 95% CI, 1.48–2.57) and 2.02 times (OR, 2.02; 95% CI, 1.13–3.60) more likely to be 25(OH)D deficient than controls. We also included 10 studies investigating the relationship between CD activity and vitamin D. Results showed that patients with active CD (CD Activity Index≥150) were more likely to have low vitamin D levels. In addition, whether low sun exposure and high latitude were related to a high morbidity of CD need to be provided more evidence.ConclusionOur study shows that IBD patients have lower vitamin D levels. For active CD patients, vitamin D levels were low. These findings suggest that vitamin D may play an important role in the development of IBD, although a direct association could not be determined in our study.

Is Low Vitamin D Status A Risk Factor For Food Allergy? Current Evidence And Future Directions.

Studies from several countries have reported an association between latitudes further from the equator and proxy markers of food allergy prevalence. As latitudes further from the equator are associated with lower sun exposure and vitamin D status (VDS), it has been proposed that low VDS may be a risk factor for food allergy. A range of basic science evidence supports the biological plausibility of this hypothesis; and recent work has identified a cross sectional association between low VDS and challenge proven food allergy in infants. Overall, however, the evidence regarding the relationship between VDS and food allergy remains controversial and the limited longitudinal data are discouraging. In this review we consider the evidence for and against low VDS as a risk factor for food allergy and discuss the possibility that other factors (including genetic variables) may contribute to the inconsistent nature of the available observational evidence. We then discuss whether genetic and/or environmental factors may modify the potential influence of VDS on food allergy risk. Finally, we argue that given the rising burden of food allergy, the balance of available evidence regarding the potential relevance of VDS to this phenomenon, and the inherent limitations of the existing observational data, there is a compelling case for conducting randomised clinical trials of vitamin D supplementation for the prevention of food allergy during early life.

Continuous Positive Airway Pressure Treatment Increases Serum Vitamin D Levels in Male Patients with Obstructive Sleep Apnea.

Recent studies report a link between obstructive sleep apnea (OSA) syndrome, low vitamin D levels, and high parathyroid hormone (PTH) concentrations. The aim of the current study is to evaluate the effect of 7-night continuous positive airway pressure (CPAP) therapy on serum vitamin D, PTH, and calcium levels in patients with severe OSA syndrome. Patients with severe OSA were enrolled into the study and compared to control subjects. Patients with OSA underwent CPAP therapy for 7 nights and were consequently divided into responders (OSA-R, mean residual AHI < 5/h) and nonresponders (OSA-nR, mean residual AHI > 5/h). Serum vitamin D, PTH, and calcium levels were measured at baseline in patients with severe OSA (apnea-hypopnea index > 30/h) and control subjects. Patients with OSA underwent a final morning blood sample after 7-night CPAP therapy. We enrolled 90 patients with OSA into the study (65 OSA-R and 25 OSA-nR) compared to 32 control subjects. At baseline, lower vitamin D and higher PTH levels were detected in the OSA group compared to controls. After 7-night CPAP therapy, male OSA-R patients showed a significant increase in vitamin D levels. Conversely, female OSA-R patients did not show the same increase in vitamin D levels. It was also observed that OSA-nR subjects did not show modifications of serum markers after nCPAP-therapy. The study demonstrates that short-term nCPAP treatment is able to promote the recovery of vitamin D homeostasis in male patients with OSA. The mediation of sexual hormones in regulating vitamin D is a possible explanation of the lack of recovery of vitamin D homeostasis in female patients with OSA as it often affects postmenopausal women.

Determinants of Vitamin D Status in Caucasian Adults: Influence of Sun Exposure, Dietary Intake, Sociodemographic, Lifestyle, Anthropometric, and Genetic Factors

Very few studies have investigated the determinants of serum vitamin D levels using a set of variables that include simultaneously sun exposure, phototype, dietary intake, sociodemographics, anthropometric, lifestyle data, and genetic polymorphisms. Our objective was to investigate the associations between all these parameters and vitamin D status in a large sample of French adults. This cross-sectional survey was based on 1,828 middle-aged Caucasian adults from the SU.VI.MAX (SUpplémentation en VItamines et Minéraux AntioXydants) study. Plasma 25-hydroxyvitamin D (25OHD) concentration was lower among women (P<0.0001), older subjects (P=0.04), obese/underweight (P<0.0001), those living at higher latitudes (P<0.0001), those whose blood draw occurred in early spring (P<0.0001), less physically active (P<0.0001), with low sun exposure (P<0.0001), and with no-to-low alcohol intake (P=0.0001). Mutant GC rs4588 and rs7041 single nucleotide polymorphisms were associated with lower and higher 25OHD concentrations, respectively (P<0.0001). Dietary intake was not a major determinant of vitamin D status (P=0.7). This study provides an overall picture of determinants of vitamin D status. Several modifiable factors were identified, such as daily-life moderate sun exposure, physical activity, and normal-weight maintenance, which should be targeted by public health policies in order to improve vitamin D status in the general population, while avoiding active/intensive sun exposure, in line with recommendations for skin cancer prevention.

Differences in Clinicopathological Features and Distribution of Risk Factors in Italian Melanoma Patients

Background: No studies are available in the literature on the distribution of different melanoma features and risk factors in the Italian geographical areas. Objective: To identify the differences in clinical-pathological features of melanoma, the distribution of risk factors and sun exposure in various Italian macro-areas. Methods: Multicentric-observational study involving 1,472 melanoma cases (713 north, 345 centre, 414 south) from 26 referral centres belonging to the Italian Multidisciplinary Group for Melanoma. Results: Melanoma patients in northern regions are younger, with thinner melanoma, multiple primaries, lower-intermediate phototype and higher counts of naevi with respect to southern patients; detection of a primary was mostly connected with a physician examination, while relatives were more involved in the south. Northern patients reported a more frequent use of sunbeds and occurrence of sunburns before melanoma despite sunscreen use and a lower sun exposure during the central hours of the day. Conclusions: The understanding of differences in risk factors distribution could represent the basis for tailored prevention programmes.

Age impact on clinical risk factors does not justify the age related change in referral pattern for osteoporosis assessment—Data from the Aalborg University Hospital Record for Osteoporosis Risk Assessment (AURORA)

BackgroundOsteoporotic fractures with subsequent disability, dependency and premature death are increasingly common with age. Yet, referral for osteoporosis evaluation decreases with age. Why is this, and is it justified? PurposeTo assess if age changes the impact of clinical risk factors for osteoporosis. MethodsClinical risk factors for osteoporosis were informed by a questionnaire and recorded in the AURORA database along with anthropometry and bone mineral density measured by dual energy X-ray absorptiometry (DXA). We included data from the first DXA in all individuals seen at the Osteoporosis Clinic in North Denmark in 2010 through 2012. ResultsRisk factor data were available in >96% and DXA in >98% of the 8131 evaluations. Age 80+ years was the dominant risk factor for fragility fracture (P<0.001) and for osteoporosis by DXA (P<0.001). The occurrence of clinical risk factors differed by age <80 or 80+ years: P<0.001 for family history, present smoker, excess alcohol intake, secondary disease, low sun exposure, fragility fracture; P=0.002 for early menopause; P=0.015 for corticosteroid; P=0.046 for low dairy product consumption. Age increased the impact of female gender (interaction term in logistic regression: P=0.004 for fragility fracture; P=0.040 for BMD). Age had no influence on the importance of any other clinical risk factor for the occurrence of fragility fracture. ConclusionHigh age carried the highest risk for fragility fracture and for osteoporosis by DXA. Clinical risk factors changed with age in those referred for evaluation. This change was not justified by the impact of clinical risk factors.

Sun exposure profile in the French population. Results of the EDIFICE Melanoma survey.

The incidence of melanoma is increasing worldwide, causing significant economic burden at community and individual levels. Ultraviolet radiation, from natural sunlight or artificial sources, is the main environmental, modifiable risk factor for melanoma. The present analysis assesses the profile of sun exposure in the French population as well as the level of awareness about ultraviolet risk and protection. The survey was conducted via telephone interviews in September and October 2011. In total, 1502 respondents were questioned about their own sun exposure with the question "do you ever, even occasionally, spend time in the sun, during leisure-time, vacation or your professional occupation?" They were also asked about sun protection measures used: protective clothing, a hat or sunscreen. More than three respondents out of four (78%) declared exposing themselves to the sun, with an average of 113 days per year. Of these, 38% did not use appropriate sun protection measures. We identified the following characteristics of individuals declaring high sun exposure: chiefly men under the age of 40, higher socio-professional levels, and adults with no children. Individuals who make a poor use of protective measures are mostly men and of low educational levels. Individuals declaring low sun exposure were chiefly: women, individuals over the age of 60, and those with no professional activity. The high sun protection population comprises mostly: women, higher socio-professional levels, with no specific age-group profile. Analysis of the EDIFICE Melanoma survey provides information about the attitudes of the French population towards sun exposure. The most frequent contexts of sun exposure and the associated socio-demographic characteristics of the population with at-risk attitudes regarding sun exposure are identified. This deeper insight into the profile of at-risk populations will allow interventions to be more accurately targeted, thus potentially improving public health benefits.

Associations of vitamin D pathway genes with circulating 25-hydroxyvitamin-D, 1,25-dihydroxyvitamin-D, and prostate cancer: a nested case-control study.

PurposeVitamin D pathway single nucleotide polymorphisms (SNPs) are potentially useful proxies for investigating whether circulating vitamin D metabolites [total 25-hydroxyvitamin-D, 25(OH)D; 1,25-dihydroxyvitamin, 1,25(OH)2D] are causally related to prostate cancer. We investigated associations of sixteen SNPs across seven genes with prostate-specific antigen-detected prostate cancer.MethodsIn a nested case–control study (within the ProtecT trial), we estimated odds ratios and 95 % confidence intervals (CIs) quantifying associations between SNPs and prostate cancer. Subgroup analyses investigated whether associations were stronger in men who had high/low sun exposure [a proxy for 25(OH)D]. We quantified associations of SNPs with stage (T1–T2/T3–T4) and grade (<7/≥7). Multiple variant scores included SNPs encoding proteins involved in 25(OH)D synthesis and metabolism.ResultsWe included 1,275 prostate cancer cases (141 locally advanced, 385 high grades) and 2,062 healthy controls. Vitamin D-binding protein SNPs were associated with prostate cancer (rs4588-A: OR 1.20, CI 1.01, 1.41, p = 0.04; rs7041-T: OR 1.19, CI 1.02, 1.38, p = 0.03). Low 25(OH)D metabolism score was associated with high (vs low) grade (OR 0.76, CI 0.63, 0.93, p = 0.01); there was a similar association of its component variants: rs6013897-A in CYP24A1 (OR 0.78, CI 0.60, 1.01, p = 0.06) and rs10877012-T in CYP27B1 (OR 0.80, CI 0.63, 1.02, p = 0.07). There was no evidence that associations differed by level of sun exposure.ConclusionWe found some evidence that vitamin D pathway SNPs were associated with prostate cancer risk and grade, but not stage. There was no evidence of an association in men with deficient vitamin D (measured by having low sun exposure).Electronic supplementary materialThe online version of this article (doi:10.1007/s10552-014-0500-5) contains supplementary material, which is available to authorized users.

PO-0985 Vitamin D Deficiency In The High Risk Somali Community In West London: Phase I Understanding The Community

Background and aims There is increasing evidence that childhood vitamin D deficiency is associated with poorer overall health and associated with numerous diseases. We wanted to assess knowledge and use of vitamin D in mothers of the Somali Community in West London with the aim of improving knowledge, access to vitamin D and reducing the burden of vitamin D associated healthcare problems in mothers and their children. Methods A representative sample of Somali individuals were contacted by HASVO (Harrow Association of Somali Voluntary Organisations) and three meetings conducted with these community members. Participants were asked to complete a detailed vitamin D questionnaire assessing baseline knowledge of vitamin D deficiency, awareness of its importance and current uptake. This was followed by an educational presentation and discussion. Questionnaires and presentations were in English and translators provided for those who required assistance. Results 45 participants completed the questionnaire. Most participants had heard of vitamin D deficiency (33), but the participants and their children were at high risk of it through lifestyle factors, particularly low sun exposure. The discussion exposed variability in both lay health beliefs and experiences with healthcare professionals. Conclusion Phase I of this study has shown that (i) there is a current vitamin D crisis in this community and knowledge is variable, (ii) clearer community information is needed about vitamin D dosage, (iii) access to cheap vitamin D needs to be better publicised. Thus, we propose that a vitamin D campaign is needed and will be rolled out in Phase II.