Whether skin photosensitivity modulates sun exposure behaviours, consequent vitamin D status and skeletal health outcomes independently of constitutive pigmentation have not been systematically investigated. 1072 community-dwelling adults aged 50–80 years had skin photosensitivity quantified by questionnaire and melanin density by spectrophotometry. Bone mineral density (BMD), falls risk and 25-hydroxyvitamin D (25OHD) were measured using DXA, short form physiological profile assessment and radioimmunoassay, respectively. Sun exposure and symptomatic fractures were assessed by questionnaire. Participants were followed up at 2.5 (n = 879), 5 (n = 767) and 10 (n = 571) years. Higher resistance to sunburn and greater ability to tan were associated with reduced sun protection behaviours (RR 0.87, p < 0.001 & RR 0.88, p < 0.001), higher lifetime discretionary sun exposure in summer (RR 1.05, p = 0.001 & RR 1.07, p = 0.001) and winter (RR 1.07, p = 0.001 & RR 1.08, p = 0.02) and fewer lifetime sunburns (RR 0.86, p < 0.001 & RR 0.91, p = 0.001). Higher resistance to sunburn was associated with lower total body (β = − 0.006, p = 0.047) and femoral neck (β = − 0.006, p = 0.038) BMD, but paradoxically, fewer prevalent fractures (RR 0.94, p = 0.042). Greater ability to tan was associated with higher 25OHD (β = 1.43, p = 0.04), lumbar spine (β = 0.014, p = 0.046) and total body (β = 0.013, p = 0.006) BMD, but not fracture or falls risk. These associations were independent of constitutive melanin density. Cutaneous photosensitivity was associated with sun exposure behaviours, cutaneous sequelae and, consequently, 25OHD and BMD in older Caucasian adults independent of constitutive melanin density. There was no consistent association with fracture outcomes, suggesting environmental factors are at least as important.

尚未系统地研究皮肤光敏性是否能调节日晒行为，随之而来的维生素D状态和骨骼健康结果，而与构成性色素沉着无关。1072个年龄在50-80岁之间的社区居民成年人的皮肤光敏性通过问卷进行了定量，黑色素密度通过分光光度法进行了定量。分别使用DXA，简短生理特征评估和放射免疫测定法测量骨矿物质密度（BMD），跌倒风险和25-羟基维生素D（25OHD）。通过问卷调查评估了阳光照射和症状性骨折。参与者分别以2.5（n  = 879），5（n  = 767）和10（n = 571）年。更高的耐晒伤性和更强的晒黑能力与降低的防晒行为有关（RR 0.87，p  <0.001＆RR 0.88，p  <0.001），夏季终身终生随意暴露于阳光下（RR 1.05，p  = 0.001＆RR 1.07，p  = 0.001）和冬季（RR 1.07，p  = 0.001＆RR 1.08，p  = 0.02）和终生晒伤（RR 0.86，p  <0.001＆RR 0.91，p  = 0.001）较少。对晒伤的较高抵抗力与较低的全身（β  = − 0.006，p  = 0.047）和股骨颈（β  = − 0.006，p = 0.038）BMD，但自相矛盾的是，较少发生的普遍骨折（RR 0.94，p  = 0.042）。棕褐色的能力增强与25OHD（β  = 1.43，p  = 0.04），腰椎（β  = 0.014，p  = 0.046）和全身（β  = 0.013，p  = 0.006）BMD升高有关，但无骨折或跌倒风险。这些关联与组成型黑色素密度无关。皮肤光敏性与日晒行为，皮肤后遗症有关，因此与年龄较长的白种人成年人的25OHD和BMD无关，而与组成型黑色素密度无关。骨折预后没有一致的关联，表明环境因素至少同样重要。