Abstract
Summary
Serum 25(OH)D levels decline without sunlight exposure. We studied 120 expeditioners to Antarctica to determine the skeletal and hormonal responses to sunlight deprivation. With emerging vitamin D insufficiency, serum calcium decreased, PTH increased, and bone loss at the proximal femur was observed. Baseline serum 25(OH)D levels >100 nmol/L prevented vitamin D insufficiency.
Introduction
Vitamin D stores deplete without adequate sunlight exposure unless supplementation is provided. We studied 120 healthy adults who spent a year in Antarctica as a model for sunlight deprivation to define the timing and magnitude of the skeletal and hormonal responses to emerging vitamin D insufficiency.
Methods
Fasting blood samples were assessed at baseline, 6 and 12 months for serum 25-hydroxyvitamin D (25(OH)D), osteocalcin (OC), bone formation (P1NP) and resorption (CTx), PTH and calcium. Lumbar spine and proximal femur BMD was measured using DXA. Differences over time were determined using repeated measures ANOVA. Percent changes were expressed as (Δ value/(value A + value B)/2) × 100. Relationships between outcome measures were determined using Spearman’s correlations.
Results
Vitamin D insufficiency (<50 nmol/L) was observed in 85% of expeditioners by 6 months when serum calcium decreased and PTH increased (p < 0.01). By 12 months, OC increased by 7.4 ± 3.0% (p < 0.05), and BMD decreased by 1.0 ± 2.0% at the total proximal femur (p < 0.05). For those with vitamin D sufficiency at baseline (>50 nmol/L), sunlight deprivation produced vitamin D insufficiency within 4 months unless baseline values were >100 nmol/L.
Conclusion
Supplementation may be necessary for expeditioners with limited access to UV light.
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Acknowledgements
The authors thank Robin Taylor, Dr. Roland Watzl and Melissa Kingston (AAD), research nurses Kylie King and Judy Tan (Austin Health), Antarctic medical practitioners Drs. Tanya Kelly, Andy Williams, Malcolm Arnold, John Birss, Graham Denyer, James Double, Jim Bumak, and Lloyd Fletcher, Drs. Colin Roy, Stuart Henderson, and Peter Gies (ARPANSA) for use of UV data, Suzanne Sparshott, Rose Ford, and Furley Johston (Menzies) and Jane Karpavicius, Tanya Mewbury, and Mary-Kate Inkster (Monash University).
Funding
This project was support by Australian Antarctic Science grants.
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Iuliano-Burns, S., Wang, X.F., Ayton, J. et al. Skeletal and hormonal responses to sunlight deprivation in Antarctic expeditioners. Osteoporos Int 20, 1523–1528 (2009). https://doi.org/10.1007/s00198-008-0830-9
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DOI: https://doi.org/10.1007/s00198-008-0830-9