Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Dermatol. 2019 Mar;46(3):206-212. doi: 10.1111/1346-8138.14742. Epub 2018 Dec 28.
This study aimed to determine the prevalence of vitamin D insufficiency among Thai dermatologists compared with the general working-age population in Bangkok. A cross-sectional study was conducted in healthy Thai physicians who had at least 1 years' experience in dermatology practise and a subsample of the general Thai population from the Fourth National Health Survey. Serum 25-hydroxyvitamin D (25[OH]D), a combination of 25(OH)D2 and 25(OH)D3, levels in both groups were measured using liquid chromatography coupled with mass spectrometry. The majority of dermatologists were of Fitzpatrick skin type III (n = 61, 61.3%) or IV (n = 32, 33.3%). The mean serum 25(OH)D and 25(OH)D3 levels were 18.9 and 18.2 ng/mL, respectively, whereas the corresponding levels in the general population were 26.5 and 25.8 ng/mL. None of the dermatologist had serum 25(OH)D sufficiency (>30 ng/mL), 38 (38.78%) had vitamin D insufficiency (20-30 ng/mL) and 60 (61.22%) had vitamin D deficiency (<20 ng/mL). The frequency of vitamin D deficiency in dermatologists was significantly higher than in the general population (61.2% vs 19.2%, P < 0.001). Ninety percent of dermatologists used sunscreen daily and spent time mostly indoors. Dermatologists used physical sun-protection more than half of the time when outdoors, for example, a book or paper as a sunshade (70.3%), an umbrella (48.4%), a long-sleeved shirt (20.4%) or a hat (9.7%). In conclusion, dermatologists showed a remarkably high prevalence of vitamin D deficiency which may be due to inadequate exposure to sunlight, regular use of sunscreen and practicing various sun-protection activities.
本研究旨在确定与曼谷普通工作年龄人群相比,泰国皮肤科医生维生素 D 不足的患病率。采用横断面研究方法,对在皮肤科有至少 1 年从业经验的泰国健康医生和第四次全国健康调查的泰国普通人群亚样本进行研究。使用液相色谱-串联质谱法测量两组人群的血清 25-羟维生素 D(25[OH]D)水平,25[OH]D2 和 25[OH]D3 的组合。大多数皮肤科医生的皮肤类型为 Fitzpatrick III 型(n = 61,61.3%)或 IV 型(n = 32,33.3%)。血清 25(OH)D 和 25(OH)D3 水平的平均值分别为 18.9 和 18.2ng/mL,而普通人群的相应水平分别为 26.5 和 25.8ng/mL。没有皮肤科医生的血清 25(OH)D 充足(>30ng/mL),38 名(38.78%)患有维生素 D 不足(20-30ng/mL),60 名(61.22%)患有维生素 D 缺乏症(<20ng/mL)。皮肤科医生维生素 D 缺乏症的发生率明显高于普通人群(61.2%比 19.2%,P<0.001)。90%的皮肤科医生每天使用防晒霜,大部分时间都在室内度过。皮肤科医生在户外时,超过一半的时间使用物理防晒措施,例如,一本书或一张纸作为遮阳伞(70.3%)、一把伞(48.4%)、长袖衬衫(20.4%)或帽子(9.7%)。总之,皮肤科医生维生素 D 缺乏症的患病率极高,这可能是由于暴露在阳光下不足、经常使用防晒霜以及进行各种防晒活动所致。