Einfluss des Lebensstils, individueller Faktoren und einer erythemunterschwelligen UV-B-Bestrahlung auf die Vitamin D-Werte

Einleitung: Vitamin D (VitD)-Mangel ist nach aktueller Studienlage bei über 60 % der deutschen Bevölkerung nachweisbar. Eine Behandlungsalternative zur oralen Substitution stellt eine Bestrahlung mit künstlichem UV (ultraviolett)-Licht dar. Die Zielstellung dieser Arbeit war zu untersuchen, ob sich ein (kurz- und langfristiger) Effekt auf die VitD-Werte im Serum mit drei UV-Bestrahlungen innerhalb einer Woche erreichen lässt. Ein weiteres Ziel war mögliche Faktoren (Lebensstil, Ernährung, individuelle Faktoren) zu identifizieren, die den VitD-Status beeinflussen können. Methodik: Die Studie fand im Winter 2011/12 in Berlin statt und wurde an 20 Probandinnen (Alter: 21-25 Jahre, Hauttyp I-III) durchgeführt. Es wurden drei Ganzkörperbestrahlungen mit sonnensimulierter UV-B-Strahlung mit einer Bestrahlungsdosis von insgesamt 3,5 SED (Hauttyp I) bzw. 4,375 SED (Hauttyp II/ III) an drei Tagen innerhalb einer Woche appliziert. Die Bestimmung der VitD-Metaboliten, 25-Hydroxyvitamin D (25(OH)D) und 1,25-Dihydroxyvitamin D (1,25(OH)2D) erfolgte vor der ersten Bestrahlung (Tag 1) sowie an Tag 8, Tag 36 und Tag 50. Am Tag der Erstuntersuchung wurde ein Dokumentationsbogen, bestehend aus einem anamnestischen, Ernährungs- und Hauttypfragebogen, erhoben. Ergebnisse: Es zeigte sich eine signifikant höhere Serumkonzentration von 25(OH)D und 1,25(OH)2D nach der Bestrahlung im Vergleich zu den Ausgangswerten. Eine signifikante, strak negative Korrelation ergab sich zwischen dem 25(OH)D-Ausgangswert und der Änderung der 25(OH)D-Serumkonzentration nach der Intervention (r = -0,74; p < 0,001). Auch vier Wochen nach der Intervention lag die Serumkonzentration von 25(OH)D im Vergleich zu dem Ausganswert signifikant höher (53,7 ± 26,6 nmol/l (Tag 1) vs. 63,0 ± 23,2 nmol/l (Tag 36), p < 0,01, für n = 16). Unter der Einnahme hormoneller Kontrazeptiva zeigte sich ein signifikant höherer 1,25(OH)2D-Serumspiegel. Es zeigte sich kein Zusammenhang weder zwischen der VitD-Aufnahme über die Ernährung noch zwischen dem Hauttyp und der Serumkonzentration von 25(OH)D und 1,25(OH)2D. Schlussfolgerungen: Drei Ganzkörperbestrahlungen mit sonnensimulierter UV-B-Strahlung innerhalb einer Woche im Winter stellen eine effektive und sichere Option dar, um die Serumkonzentration von 25(OH)D und 1,25(OH)2D signifikant zu erhöhen. Nur wenige Faktoren beeinflussen signifikant VitD-Werte im Serum.Over 60 % of the German population shows VitD deficiency. UV radiation is an alternative solution for the oral treatment. The aim of this study was to investigate if there is an effect (short- and long-term) of three whole body UV exposures during one week on the level of VitD metabolites and to identify possible factors (life-style, nutrition, individual factors), which have an influence on VitD status. Methods: 20 healthy female subjects (age: 21 - 25 years, UV skin type: I - III) were included in the study, which took place in winter 2011/12 in Berlin. The study participants received three whole body irradiation with an solar simulated UV-B stimulus on three days during one week. The dose of the UV-B stimulus came to altogether 3,5 SED (UV skin type I) and 4,375 SED (UV skin type II/ III) respectively. The level of the VitD metabolites, 25(OH)D and 1,25(OH)2D, were measured before the first irradiation (day 1) and on day 8, day 36 and day 50. A questionnaire including demographic, nutritional and skin type questions has been enquired on day 1. Results: The level of 25(OH)D and 1,25(OH)2D increased significantly after UV-B exposures. The baseline level of 25(OH)D correlated strongly and negatively with the increment of 25(OH)D (r = -0,74; p < 0,001). 25(OH)D remained significantly increased above baseline for weeks after the irradiation (53,7 ± 26,6 nmol/l (day 1) vs. 63,0 ± 23,2 nmol/l (day 36), p < 0,01, for n = 16). Oral contraceptive users had a significantly higher baseline level of 1,25(OH)2D in comparison with non-users. There was no correlation neither with the VitD intake in a diet nor with the skin type and the baseline level of 25(OH)D and 1,25(OH)2D. Conclusions: Three whole body solar simulated UV exposures during one week in winter are an effective and safety option to increase significantly the level of 25(OH)D and 1,25(OH)2D. Only a few factors influence significantly VitD metabolites

Sustained Increase of 25-Hydroxyvitamin D Levels in Healthy Young Women during Wintertime after Three Suberythemal UV Irradiations—The MUVY Pilot Study

Objectives Vitamin D (VitD) deficiency is a health problem prevalent not only in the elderly but also in young adults. The primary objective of our observational pilot study “MUVY” (Mood, UVR, Vitamin D in Young women) was to test both the short-term and long-term effects of a series of three suberythemal UV radiation (UVR) exposures on the VitD status and well-being of young healthy women during winter in a repeat measure design. Methods 20 healthy young women (Fitzpatrick skin types I–III, aged 21–25 years) received three full body broad band UVR exposures with an escalating erythemally weighted dose schedule during one week in winter, and completed self-report questionnaires monitoring symptoms of depression (Beck Depression Inventory, BDI) and affective state/well-being (Profile of Mood States, POMS) at baseline and three days after the last UVR exposure. 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D) were measured in serum at baseline, and at study days 8, 36 and 50. Results Mean baseline 25(OH)D level was 54.3 nmol/L (standard deviation (s.d.) = 24.1), with seven women having VitD deficient status. Relevant symptoms of depression, as indicated by low BDI total scores (0–8), were absent. After the three UVR exposures the increment of 25(OH)D was an average of 13.9 nmol/L (95% confidence interval (CI) = 9.4–18.4) and 26.2 pmol/L (95%CI = 7.2–45.1) for 1,25(OH)2D. Δ25(OH)D, and corresponding baseline levels were significantly and inversely associated (rho = -0.493, p = 0.027). Only 25(OH)D remained significantly increased above baseline for at least six weeks after the last UVR exposure. A strong inverse correlation of the POMS subscale “Vigor/Activity” and the increment in 1,25(OH)2D was found (rho = -0.739, p<0.001) at day 8. Conclusions Three suberythemal whole body UVR exposures during one week are a simple and suitable method for improving 25(OH)D levels during winter, for at least six weeks, and especially in young women with VitD deficient status. Trial Registration German Clinical Trials Register (Deutsches Register Kinischer Studien) DRKS0000927

Scatterplot diagram, relationship between POMS subscale Vigor/Activity and the increment in 1,25-dihydroxyvitamin D at day 8 (linear regression analysis, r² = 0.445, p<0.001). The solid line is the linear fit and dashed lines are the 95% confidence limits to the fit.

<p>Scatterplot diagram, relationship between POMS subscale Vigor/Activity and the increment in 1,25-dihydroxyvitamin D at day 8 (linear regression analysis, r² = 0.445, p<0.001). The solid line is the linear fit and dashed lines are the 95% confidence limits to the fit.</p

Individual Vitamin D status as expressed by 25-hydroxyvitamin D concentration in plasma during the study.

<p>Individual Vitamin D status as expressed by 25-hydroxyvitamin D concentration in plasma during the study.</p

Baseline characteristics of subject group.

<p>Baseline characteristics of subject group.</p

25-hydroxyvitamin D and 1,25-dihydroxyvitamin D at baseline, day 8, day 36, day 50 and change from baseline.

<p>25-hydroxyvitamin D and 1,25-dihydroxyvitamin D at baseline, day 8, day 36, day 50 and change from baseline.</p

Scatterplot diagram, relationship between increase in 25-hydroxyvitamin D at day 8 and baseline 25-hydroxyvitamin D levels (quadratic regression analysis, r² = 0.607, p<0.001) The solid line is the quadratic fit, and dashed lines are the 95% confidence limits to the fit.

<p>Scatterplot diagram, relationship between increase in 25-hydroxyvitamin D at day 8 and baseline 25-hydroxyvitamin D levels (quadratic regression analysis, r² = 0.607, p<0.001) The solid line is the quadratic fit, and dashed lines are the 95% confidence limits to the fit.</p