Ladizesky M, Lu Z, Oliveri B, San Roman N, Diaz S, Holick M F, Mautalen C
Sección Osteopatías Médicas, Hospital de Clínicas, Facultad de Medicina, Universidad de Buenos Aires, Argentina.
J Bone Miner Res. 1995 Apr;10(4):545-9. doi: 10.1002/jbmr.5650100406.
The incidence of nutritional rickets in the southern part of Argentina is 8-12 times higher than in the rest of the country. Winter 25(OH)D serum levels in normal population of southern areas are lower than in central and northern areas. To elucidate these differences, we compared the photoconversion of provitamin D3 (7-DHC) to previtamin D3 in two cities: Ushuaia (latitude 55 degrees S) and Buenos Aires (34 degrees S). Ampules containing 7-DHC were exposed to sunlight one day in the middle of each month either from 10:30 a.m. to 2:30 p.m. or from 8:00 a.m. to 5:00 p.m. The percentages of photoproducts formed were determined by high performance liquid chromatography (HPLC). Previous studies have proved that this is a valid model to assess "in vitro" the photoproduction of vitamin D3 in human skin. Previtamin D3 + vitamin D3 formed in Ushuaia were less (p < 0.02) than those found in Buenos Aires during all seasons: summer, (X +/- SEM) 6.4 +/- 0.8% vs. 13.2 +/- 1.8%; autumn, 1.2 +/- 0.7% vs. 6.3 +/- 1.3%; winter, 0.8 +/- 0.7% vs. 3.6 +/- 0.7%; spring, 3.4 +/- 0.5% vs. 9.1 +/- 1.1%. The photoproducts produced from 10:30 a.m. to 2:30 p.m. were similar for each month and latitude to those formed when the ampules were exposed from 8:00 a.m. to 5:00 p.m. We conclude that in Ushuaia there is a prolonged "vitamin D winter" during which cutaneous synthesis of vitamin D is absent, leading to lower serum values of 25(OH)D and contributing to the higher incidence of rickets.
阿根廷南部营养性佝偻病的发病率比该国其他地区高8至12倍。南部地区正常人群冬季血清25(OH)D水平低于中部和北部地区。为阐明这些差异,我们比较了两个城市(乌斯怀亚,南纬55度;布宜诺斯艾利斯,南纬34度)中维生素原D3(7-DHC)向维生素前体D3的光转化情况。装有7-DHC的安瓿在每个月中旬的一天,上午10:30至下午2:30或上午8:00至下午5:00暴露于阳光下。通过高效液相色谱法(HPLC)测定形成的光产物百分比。先前的研究已证明这是一个评估人体皮肤中维生素D3“体外”光生成的有效模型。在所有季节中,乌斯怀亚形成的维生素前体D3 + 维生素D3均比布宜诺斯艾利斯少(p < 0.02):夏季,(X +/- SEM)6.4 +/- 0.8% 对13.2 +/- 1.8%;秋季,1.2 +/- 0.7% 对6.3 +/- 1.3%;冬季,0.8 +/- 0.7% 对3.6 +/- 0.7%;春季,3.4 +/- 0.5% 对9.1 +/- 1.1%。上午10:30至下午2:30产生的光产物在每个月和每个纬度与安瓿在上午8:00至下午5:00暴露时形成的光产物相似。我们得出结论,在乌斯怀亚存在一个延长的“维生素D冬季”,在此期间皮肤无法合成维生素D,导致血清25(OH)D值降低,并促使佝偻病发病率升高。