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Uncovering the Relationship Between Skin Pigmentation and Bone Density
Jay Cheeti1, Milena Jovanovic1, Catherine M Gordon1
1Section on Adolescent Bone and Body Composition, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
Pediatrics
|June 17, 2026
Summary
This review advocates for replacing race-based definitions with quantitative skin tone measures in bone mineral density (BMD) research. Understanding the interplay of genetics, vitamin D, and environmental factors is crucial for accurate BMD interpretation.
Area of Science:
- Biomedical research
- Anthropometry
- Bone health
Background:
- Bone mineral density (BMD) interpretation historically relies on socially constructed race categories.
- These race-based definitions may not accurately reflect genetic and environmental influences on BMD.
- Existing BMD interpretation frameworks impact individuals of all racial backgrounds, including mixed-race individuals.
Purpose of the Study:
- To review evidence supporting a shift from race-based to quantitative skin tone measures in BMD research.
- To emphasize the importance of considering vitamin D status, genetics, and environmental factors in BMD assessment.
- To advocate for a more empirical approach to understanding the relationship between skin tone and BMD.
Main Methods:
- Literature review of studies examining race, skin pigmentation, vitamin D status, and BMD.
- Analysis of the impact of genetic and environmental factors on skin tone and BMD.
- Synthesis of evidence for a quantitative approach to skin tone assessment in relation to BMD.
Main Results:
- Race is a significant but potentially flawed factor in current BMD interpretation.
- Skin tone, influenced by vitamin D status and ultraviolet B (UVB) exposure, directly impacts BMD.
- Genetics plays a crucial role in determining both skin tone and BMD.
Conclusions:
- Moving away from race-based definitions towards quantitative skin tone measures is essential for accurate BMD interpretation.
- A comprehensive approach integrating genetic underpinnings and environmental factors is necessary.
- Future research should prioritize empirical measures of skin tone and its complex relationship with BMD and vitamin D status.
Related Concept Videos
01:19Pigmentation
The color of the skin is influenced by a number of pigments, including melanin, carotene, and hemoglobin. Recall that melanin is produced by cells called melanocytes, which are found scattered throughout the stratum basale of the epidermis. The melanin is transferred to the keratinocytes via melanosomes.
Melanin occurs in two primary forms: eumelanin that provides black and brown pigment and pheomelanin that provides red color. Dark-skinned individuals produce more melanin than those with pale...
Melanin occurs in two primary forms: eumelanin that provides black and brown pigment and pheomelanin that provides red color. Dark-skinned individuals produce more melanin than those with pale...
01:14Changes in Skin Color: Clinical Perspectives
The first thing a clinician sees is the skin, so the examination of the skin should be part of any thorough physical examination. Most skin disorders are relatively benign, but a few, including melanomas, can be fatal if untreated. A couple of the more noticeable disorders, albinism and vitiligo, affect the appearance of the skin and its accessory organs.
Albinism
Albinism is a genetic disorder that affects (completely or partially) the coloring of skin, hair, and eyes. The defect is primarily...
Albinism
Albinism is a genetic disorder that affects (completely or partially) the coloring of skin, hair, and eyes. The defect is primarily...
01:23Role of Skin in Vitamin D Synthesis
The skin plays a crucial role in the synthesis of vitamin D, a vital nutrient for various physiological processes in the body. Vitamin D is unique because it can be synthesized in the skin through a series of chemical reactions triggered by exposure to ultraviolet B (UVB) radiation from sunlight.
The solar UV B rays (290-315 nm) are absorbed by the skin, and 7-dehydrocholesterol (provitamin D3) photolyzes it to previtamin D3, which undergoes a rapid transformation to vitamin D3(cholecalciferol).
The solar UV B rays (290-315 nm) are absorbed by the skin, and 7-dehydrocholesterol (provitamin D3) photolyzes it to previtamin D3, which undergoes a rapid transformation to vitamin D3(cholecalciferol).
01:40Bone Remodeling
Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
01:29Bone Disorders
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:55Bone Structure
Within the skeletal system, the structure of a bone, or osseous tissue, can be exemplified in a long bone, like the femur, where there are two types of osseous tissue: cortical and cancellous.