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Vitamin-D deficiency
Mean serum 25(OH)D levels decreasing in all categories of US Population* ! Vitamin D: essential for bone health ! Insufficiency possibly** associated with: ! Cardiovascular disease ! Prostate cancer ! Infection
!
25-hydroxyvitamin D (25-hydroxycholecalciferol)
The D-Lemma: If sun is necessary, how do we assess risks of low vitamin-D levels with risks of UVB exposure and make recommendations?
Critical Thinking
Is sun exposure really correlated with healthy vitamin D levels? ! Perform an observational study of individuals with habitually high sun exposure
! Target population ! Healthy individuals receiving high levels of UVB exposure ! Sample ! 93 surfers* ! 22.4 hours/week unprotected sun exposure ! Clinically tanned
Binkley, N., et al. Journal of clinical endocrinology & metabolism 92.6 (2007): 2130-2135.
If the standard deviation of the target population is known, or assumed. Otherwise, use Students t-Distribution
[25(OH)D] (ng/mL)
30
40
Assumes population standard deviation of 15, so that ! x = ! If using Students t-Distribution, use s = 3.4 ng/mL and sx =
n = 15
93 " 1.5
[25(OH)D] (ng/mL)
Binkley, N., et al. Journal of clinical endocrinology & metabolism 92.6 (2007): 2130-2135.
Probability
31.6
40
[25(OH)D] (ng/mL)
P-Value obtained using Applet found at: http://davidmlane.com/hyperstat/z_table.html
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