concentration, in conjunction with 25(OH)D, has proven to be a valuable indicator of vitamin D status.

The few studies conducted in African Americans and Mexican Americans suggest that these population groups have lower circulating concentrations of 25(OH)D and higher serum concentrations of PTH and 1,25(OH)2D when compared with Caucasians (Bell et al., 1985; Reasner et al., 1990). It is likely that increased melanin pigmentation (which decreases the cutaneous production of vitamin D) and the lack of dietary vitamin D (due to a high incidence of lactose intolerance) are the contributing causes for this.

Serum Vitamin D

The serum concentration of vitamin D is not indicative of vitamin D status. As stated previously, its half-life is relatively short, and the blood concentrations can range from 0 to greater than 250 nmol/liter (0 to 100 ng/ml) depending on an individual's recent ingestion of vitamin D and exposure to sunlight.

Serum 1,25(OH)2D

Similarly, the serum 1,25(OH)2D level is not a good indicator of vitamin D. This hormone's serum concentrations are tightly regulated by a variety of factors, including circulating levels of serum calcium, phosphorus, parathyroid hormone, and other hormones (Fraser, 1980; Holick, 1995).

Evaluation of Skeletal Health

The ultimate effect of vitamin D on human health is maintenance of a healthy skeleton. Thus, in reviewing the literature for determining vitamin D status, one of the indicators that has proven to be valuable is an evaluation of skeletal health. In neonates and children, bone development and the prevention of rickets, either in combination with serum 25(OH)D and PTH concentrations, or by itself, are good indicators of vitamin D status (Gultekin et al., 1987; Koo et al., 1995; Kruse et al., 1984; Markested et al., 1986; Meulmeester et al., 1990). For adults, bone mineral content (BMC), bone mineral density (BMD), and fracture risk, in combination with serum 25(OH)D and PTH concentrations, have proven to be the most valuable indicators of vitamin D status (Brazier et al., 1995; Dawson-



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