The Impact of Minimal Sunlight Exposure on Bone Health: Insights From a Cohort Study in Erythropoietic Protoporphyria
Authors' conclusion
25-hydroxyvitamin D (25(OH)D) status plays a crucial role in both preventing low BMD and improving BMD. EPP is a natural model for lack of sunlight exposure and vitamin D deficiency, underlining the importance of lifelong adequate vitamin D status for bone health in the general population.
Study context
- Population
- Adults with erythropoietic protoporphyria (EPP) with at least one DXA scan between 2012 and 2023
- Participants
- 139 adults
- Outcome
- Low BMD and factors associated with low BMD and BMD improvement
Methodological detailslongitudinal, single-centre
- Longitudinal
- Single-centre
Main finding
As reported in the abstract
Low BMD at baseline
- Z-score below 0 SD at baseline
- 82.7%
- Osteopenia
- 39.5%
- Osteoporosis
- 15.3%
- Odds of low bone mineral density (BMD) with aging, OR
- 1.08 (1.03-1.12) (CI)
- Odds of low BMD with persistent vitamin D deficiency, OR
- 1.11 (1.00-1.23) (95% CI)
- Odds of low BMD with BMI, OR (95% CI); low BMI increased the odds
- 0.91 (0.82-0.99)
Observational data: associations, not effects.
Further findings
Osteoporosis-related fractures
- Osteoporosis-related fractures
- 50
- Patients with osteoporosis-related fractures
- 34.2%
Improvement of BMD
- Vitamin D deficiency, OR
- 5.51 (1.69-17.92) (95% CI)
- No cholecalciferol at baseline, OR
- 0.22 (0.04-1.34) (95% CI)
- Afamelanotide did not improve BMD
- Patients with vitamin D deficiency and no cholecalciferol at baseline had the highest odds of improving BMD
Original publication
The Impact of Minimal Sunlight Exposure on Bone Health: Insights From a Cohort Study in Erythropoietic Protoporphyria. J Clin Endocrinol Metab. Published 14 October 2024. doi:10.
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