Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania.
Center for Outcomes Research and Evaluation, Carolinas HealthCare System, Charlotte, North Carolina.
Pediatr Res. 2017 Sep;82(3):444-451. doi: 10.1038/pr.2017.114. Epub 2017 May 24.
BackgroundSkin color, a vitamin D status determinant, can be assessed subjectively by Fitzpatrick sun-reactive skin typing (FST) and objectively by melanin index (MI). FST was validated against MI for discerning vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) <20 ng/ml) in children.MethodsWe measured FST, MI, and serum 25(OH)D in healthy, 8- to 18-year-old children from one of two vitamin D trials. MI from forehead, hand, and upper arm split at the median of the more racially balanced study cohort and FST (I-III vs. IV-V) were used for discriminating vitamin D deficiency.ResultsA total of 296 participants (mean age, 12.3±2.3 years; black, 208; FST IV-V, 209; 25(OH)D <20 ng/ml, 159) were studied. MI and FST had a strong positive association. Serum 25(OH)D was negatively associated with MI and FST. Sensitivity, specificity, and predictive values were similar for discriminating vitamin D deficiency between higher vs. lower MI and between FST I-III vs. IV-V. ROC area under the curves for FST (0.59) and MI (forehead (0.63); hand (0.62); and arm (0.64)) were similar.ConclusionsFST is comparable to MI for discerning vitamin D deficiency and can be deemed as an inexpensive, useful surrogate measure of skin color in the context of vitamin D research.
肤色是维生素 D 状况的决定因素，可通过 Fitzpatrick 光敏感皮肤分型（FST）进行主观评估，也可通过黑色素指数（MI）进行客观评估。FST 已通过 MI 验证，可用于鉴别儿童维生素 D 缺乏症（血清 25-羟维生素 D（25(OH)D）<20ng/ml）。
我们测量了来自两项维生素 D 试验之一的 8-18 岁健康儿童的 FST、MI 和血清 25(OH)D。MI 来自额部、手部和上臂，将更具种族平衡的研究队列的中位数分开，FST（I-III 与 IV-V）用于鉴别维生素 D 缺乏症。
共研究了 296 名参与者（平均年龄 12.3±2.3 岁；黑人 208 人；FST IV-V 209 人；血清 25(OH)D <20ng/ml 159 人）。MI 和 FST 呈强正相关。血清 25(OH)D 与 MI 和 FST 呈负相关。在较高 vs. 较低 MI 之间和 FST I-III vs. IV-V 之间鉴别维生素 D 缺乏症时，MI 和 FST 的敏感性、特异性和预测值相似。FST（ROC 曲线下面积为 0.59）和 MI（额部（0.63）；手部（0.62）；和手臂（0.64））的曲线下面积相似。
FST 与 MI 鉴别维生素 D 缺乏症的能力相当，可被视为维生素 D 研究中评估肤色的一种廉价、有用的替代指标。
