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Development of an algorithm to predict serum vitamin D levels using a simple questionnaire based on sunlight exposure

  • Endocrine Methods and Techniques
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Abstract

Sun exposure is the main determinant of vitamin D production. The aim of this study was to develop an algorithm to assess individual vitamin D status, independently of serum 25(OHD) measurement, using a simple questionnaire, mostly relying upon sunlight exposure, which might help select subjects requiring serum 25(OHD) measurement. Six hundred and twenty adult subjects living in a mountain village in Southern Italy, located at 954 m above the sea level and at a latitude of 40°50′11″76N, were asked to fill the questionnaire in two different periods of the year: August 2010 and March 2011. Seven predictors were considered: month of investigation, age, sex, BMI, average daily sunlight exposure, beach holidays in the past 12 months, and frequency of going outdoors. The statistical model assumes four classes of serum 25(OHD) concentrations: ≤10, 10–19.9, 20–29.9, and ≥30 ng/ml. The algorithm was developed using a two-step procedure. In Step 1, the linear regression equation was defined in 385 randomly selected subjects. In Step 2, the predictive ability of the regression model was tested in the remaining 235 subjects. Seasonality, daily sunlight exposure and beach holidays in the past 12 months accounted for 27.9, 13.5, and 6.4 % of the explained variance in predicting vitamin D status, respectively. The algorithm performed extremely well: 212 of 235 (90.2 %) subjects were assigned to the correct vitamin D status. In conclusion, our pilot study demonstrates that an algorithm to estimate the vitamin D status can be developed using a simple questionnaire based on sunlight exposure.

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Acknowledgments

This work would not have been possible without the collaborative efforts of many members of the staff of the Endocrine Unit 1 and 2 of the University Hospital of Pisa. We thank the following doctors: Fabrizio Aghini Lombardi, Lucia Antonangeli, Brunella Bagattini, Silvia Chiavistelli, Melissa De Servi, Scilla Del Ghianda, Antonio Dimida, Emilio Fiore, Lucia Grasso, Angelo Molinaro, Lucia Montanelli, Filippo Niccolai, Aldo Pinchera, Anna Teresa, Provenzale, Luciana Puleo, Teresa Rago, Laura Russo, Maria Scutari, Massimo Tonacchera, and Paolo Vitti. We also thank Mr Adolfo Pardini for computer assistance. We also thank the local authorities and in particular Mr Antonio Araneo, mayor of the village, and Dr Carmela Silvestri, family doctor.

Funding

This study did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

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Author notes

  1. Luisella Cianferotti

    Present address: Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy

Authors and Affiliations

  1. Endocrine Unit 2, University Hospital of Pisa, Pisa, Italy

    Edda Vignali & Filomena Cetani

  2. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

    Enrico Macchia, Luisella Cianferotti, Federica Saponaro & Claudio Marcocci

  3. Biostatistics Unit, Medi Service, Genoa, Italy

    Giorgio Reggiardo

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  1. Edda Vignali
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  2. Enrico Macchia
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Correspondence to Claudio Marcocci.

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Vignali, E., Macchia, E., Cetani, F. et al. Development of an algorithm to predict serum vitamin D levels using a simple questionnaire based on sunlight exposure. Endocrine 55, 85–92 (2017). https://doi.org/10.1007/s12020-016-0901-1

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