scholarly journals Vitamin D testing and treatment: a narrative review of current evidence

2019 ◽  
Vol 8 (2) ◽  
pp. R27-R43 ◽  
Author(s):  
Stefan Pilz ◽  
Armin Zittermann ◽  
Christian Trummer ◽  
Verena Theiler-Schwetz ◽  
Elisabeth Lerchbaum ◽  
...  

Vitamin D testing and treatment is a subject of controversial scientific discussions, and it is challenging to navigate through the expanding vitamin D literature with heterogeneous and partially opposed opinions and recommendations. In this narrative review, we aim to provide an update on vitamin D guidelines and the current evidence on the role of vitamin D for human health with its subsequent implications for patient care and public health issues. Vitamin D is critical for bone and mineral metabolism, and it is established that vitamin D deficiency can cause rickets and osteomalacia. While many guidelines recommend target serum 25-hydroxyvitamin D (25[OH]D) concentrations of ≥50 nmol/L (20 ng/mL), the minimum consensus in the scientific community is that serum 25(OH)D concentrations below 25–30 nmol/L (10–12 ng/mL) must be prevented and treated. Using this latter threshold of serum 25(OH)D concentrations, it has been documented that there is a high worldwide prevalence of vitamin D deficiency that may require public health actions such as vitamin D food fortification. On the other hand, there is also reason for concern that an exploding rate of vitamin D testing and supplementation increases costs and might potentially be harmful. In the scientific debate on vitamin D, we should consider that nutrient trials differ from drug trials and that apart from the opposed positions regarding indications for vitamin D treatment we still have to better characterize the precise role of vitamin D for human health.

2012 ◽  
Vol 108 (11) ◽  
pp. 1915-1923 ◽  
Author(s):  
Cherlyn Ding ◽  
Dan Gao ◽  
John Wilding ◽  
Paul Trayhurn ◽  
Chen Bing

Vitamin D deficiency and the rapid increase in the prevalence of obesity are both considered important public health issues. The classical role of vitamin D is in Ca homoeostasis and bone metabolism. Growing evidence suggests that the vitamin D system has a range of physiological functions, with vitamin D deficiency contributing to the pathogenesis of several major diseases, including obesity and the metabolic syndrome. Clinical studies have shown that obese individuals tend to have a low vitamin D status, which may link to the dysregulation of white adipose tissue. Recent studies suggest that adipose tissue may be a direct target of vitamin D. The expression of both the vitamin D receptor and 25-hydroxyvitamin D 1α-hydroxylase (CYP27B1) genes has been shown in murine and human adipocytes. There is evidence that vitamin D affects body fat mass by inhibiting adipogenic transcription factors and lipid accumulation during adipocyte differentiation. Some recent studies demonstrate that vitamin D metabolites also influence adipokine production and the inflammatory response in adipose tissue. Therefore, vitamin D deficiency may compromise the normal metabolic functioning of adipose tissue. Given the importance of the tissue in energy balance, lipid metabolism and inflammation in obesity, understanding the mechanisms of vitamin D action in adipocytes may have a significant impact on the maintenance of metabolic health. In the present review, we focus on the signalling role of vitamin D in adipocytes, particularly the potential mechanisms through which vitamin D may influence adipose tissue development and function.


2021 ◽  
Vol 7 (1) ◽  
pp. e19-e19
Author(s):  
Alireza Pouramini ◽  
Fatemeh Kafi ◽  
Shakiba Hassanzadeh

COVID-19 infection increases the risk of death in patients with chronic conditions such as diabetes or obesity. The exact role of vitamin D in COVID-19 infection is unknown and controversial. Furthermore, the exact prevalence of vitamin D deficiency is still unknown but it affects individuals worldwide regardless of ethnicity and age. Herein, we give an overview of vitamin D deficiency as a global public health problem, the role of vitamin D in COVID-19 infection, and the proper approach to treating vitamin D deficiency.


2018 ◽  
Vol 40 (4) ◽  
pp. 1109-1151 ◽  
Author(s):  
Roger Bouillon ◽  
Claudio Marcocci ◽  
Geert Carmeliet ◽  
Daniel Bikle ◽  
John H White ◽  
...  

AbstractThe etiology of endemic rickets was discovered a century ago. Vitamin D is the precursor of 25-hydroxyvitamin D and other metabolites, including 1,25(OH)2D, the ligand for the vitamin D receptor (VDR). The effects of the vitamin D endocrine system on bone and its growth plate are primarily indirect and mediated by its effect on intestinal calcium transport and serum calcium and phosphate homeostasis. Rickets and osteomalacia can be prevented by daily supplements of 400 IU of vitamin D. Vitamin D deficiency (serum 25-hydroxyvitamin D <50 nmol/L) accelerates bone turnover, bone loss, and osteoporotic fractures. These risks can be reduced by 800 IU of vitamin D together with an appropriate calcium intake, given to institutionalized or vitamin D–deficient elderly subjects. VDR and vitamin D metabolic enzymes are widely expressed. Numerous genetic, molecular, cellular, and animal studies strongly suggest that vitamin D signaling has many extraskeletal effects. These include regulation of cell proliferation, immune and muscle function, skin differentiation, and reproduction, as well as vascular and metabolic properties. From observational studies in human subjects, poor vitamin D status is associated with nearly all diseases predicted by these extraskeletal actions. Results of randomized controlled trials and Mendelian randomization studies are supportive of vitamin D supplementation in reducing the incidence of some diseases, but, globally, conclusions are mixed. These findings point to a need for continued ongoing and future basic and clinical studies to better define whether vitamin D status can be optimized to improve many aspects of human health. Vitamin D deficiency enhances the risk of osteoporotic fractures and is associated with many diseases. We review what is established and what is plausible regarding the health effects of vitamin D.


2017 ◽  
Vol 118 (7) ◽  
pp. 550-558 ◽  
Author(s):  
Yannis Manios ◽  
George Moschonis ◽  
Toine Hulshof ◽  
Anne-Sophie Bourhis ◽  
George L. J. Hull ◽  
...  

AbstractThe current study was aiming to report the prevalence of suboptimal vitamin D status among schoolchildren in Greece and investigate the role of sex, urbanisation and seasonality on vitamin D status. A sample of 2386 schoolchildren (9–13 years old) from four distinct prefectures was examined. The prevalence of 25-hydroxyvitamin D (25(OH)D) concentration <30 and <50 nmol/l (vitamin D deficiency and insufficiency respectively) was 5·2 and 52·5 %, respectively. Girls had a higher prevalence of 25(OH)D<30 (7·2 v. 3·2 %) and 50 nmol/l (57·0 v. 48·0 %) than boys (P<0·001). The highest prevalence rates of 25(OH)D<30 and 50 nmol/l (9·1 and 73·1 %, respectively) were observed during spring (April to June), whereas the lowest (1·5 and 31·9 %, respectively) during autumn (October to December). The prevalence of 25(OH)D<50 nmol/l was higher in urban/semi-urban than rural regions, particularly during spring months (74·6 v. 47·2 %; P<0·001). Female sex, urban/semi-urban region of residence and spring months were found to increase the likelihood of vitamin D deficiency and insufficiency, with the highest OR observed for spring months (7·47; 95 % CI 3·23, 17·3 and 5·14; 95 % CI 3·84, 6·89 for 25(OH)D<30 and 50 nmol/l respectively). In conclusion, despite the southerly latitude, the prevalence of low vitamin D status among primary schoolchildren in Greece is comparable to or exceeds the prevalence reported among children and adolescents on a European level. Sub-populations at highest risk are girls in urban/semi-urban areas during spring months, thus indicating the need for effective initiatives to support adequate vitamin D status in these population groups.


COVID ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 97-104
Author(s):  
Pranta Das ◽  
Nandeeta Samad ◽  
Bright Opoku Ahinkorah ◽  
John Elvis Hagan ◽  
Prince Peprah ◽  
...  

One major micronutrient studied for its possible protective effect against the COVID-19 disease is vitamin D. This systematic review sought to identify and synthesize available evidence to aid the understanding of the possible effect of vitamin D deficiency on COVID-19 status and health outcomes in COVID-19 patients. Three databases (PubMed, ScienceDirect, and Google Scholar) were systematically used to obtain English language journal articles published between 1 December 2019 and 3 November 2020. The search consisted of the terms (“Vitamin D,” OR “25-Hydroxyvitamin D,” OR “Low vitamin D.”) AND (“COVID-19” OR “2019-nCoV” OR “Coronavirus” OR “SARS-CoV-2”) AND (“disease severity” OR “IMV” OR “ICU admission” OR “mortality” OR “hospitalization” OR “infection”). We followed the recommended PRISMA guidelines in executing this study. After going through the screening of the articles, eleven articles were included in the review. All the included studies reported a positive association between vitamin D sufficiency and improved COVID-19 disease outcomes. On the other hand, vitamin D deficiency was associated with poor COVID-19 disease outcomes. Specifically, two studies found that vitamin D-deficient patients were more likely to die from COVID-19 compared to vitamin D-sufficient patients. Three studies showed that vitamin D-deficient people were more likely to develop severe COVID-19 disease compared to vitamin D-sufficient people. Furthermore, six studies found that vitamin D-deficient people were more likely to be COVID-19 infected compared to vitamin D-sufficient people. Findings from these studies suggest that vitamin D may serve as a mitigating effect for COVID-19 infection, severity, and mortality. The current evidence supports the recommendations for people to eat foods rich in vitamin D such as fish, red meat, liver, and egg yolks. The evidence also supports the provision of vitamin D supplements to individuals with COVID-19 disease and those at risk of COVID-19 infection in order to boost their immunity and improve health outcomes.


2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Anna Mazanova ◽  
Ihor Shymanskyi ◽  
Olha Lisakovska ◽  
Lala Hajiyeva ◽  
Yulia Komisarenko ◽  
...  

Objectives.Recent prospective studies have found the associations between type 1 diabetes (T1D) and vitamin D deficiency. We investigated the role of vitamin D in the regulation of 25OHD-1α-hydroxylase (CYP27B1) and VDR expression in different tissues of T1D rats.Design.T1D was induced in male Wistar rats by streptozotocin (55 mg/k b.w.). After 2 weeks of T1D, the animals were treated orally with or without vitamin D3(cholecalciferol; 100 IU/rat, 30 days).Methods.Serum 25-hydroxyvitamin D (25OHD) was detected by ELISA. CYP27A1, CYP2R1, CYP27B1, and VDR were assayed by RT-qPCR and Western blotting or visualized by immunofluorescence staining.Results.We demonstrated that T1D led to a decrease in blood 25OHD, which is probably due to the established downregulation of CYP27A1 and CYP2R1 expression. Vitamin D deficiency was accompanied by elevated synthesis of renal CYP27B1 and VDR. Conversely, CYP27B1 and VDR expression decreased in the liver, bone tissue, and bone marrow. Cholecalciferol administration countered the impairments of the vitamin D-endo/para/autocrine system in the kidneys and extrarenal tissues of diabetic rats.Conclusions.T1D-induced vitamin D deficiency is associated with impairments of renal and extrarenal CYP27B1 and VDR expression. Cholecalciferol can be effective in the amelioration of diabetes-associated abnormalities in the vitamin D-endo/para/autocrine system.


Metabolites ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 499
Author(s):  
Fernanda C. Chacar ◽  
Márcia M. Kogika ◽  
Rafael V. A. Zafalon ◽  
Marcio A. Brunetto

Some differences regarding Vitamin D metabolism are described in dogs and cats in comparison with humans, which may be explained by an evolutionary drive among these species. Similarly, vitamin D is one of the most important regulators of mineral metabolism in dogs and cats, as well as in humans. Mineral metabolism is intrinsically related to bone metabolism, thus disturbances in vitamin D have been implicated in the development of chronic kidney disease mineral and bone disorders (CKD-MBD) in people, in addition to dogs and cats. Vitamin D deficiency may be associated with Renal Secondary Hyperparathyroidism (RSHPT), which is the most common mineral disorder in later stages of CKD in dogs and cats. Herein, we review the peculiarities of vitamin D metabolism in these species in comparison with humans, and the role of vitamin D disturbances in the development of CKD-MBD among dogs, cats, and people. Comparative studies may offer some evidence to help further research about vitamin D metabolism and bone disorders in CKD.


Author(s):  
Roya Ghasemian ◽  
Amir Shamshirian ◽  
Keyvan Heydari ◽  
Mohammad Malekan ◽  
Reza Alizadeh-Navaei ◽  
...  

AbstractBackgroundEvidence recommends that vitamin D might be a crucial supportive agent for the immune system, mainly in cytokine response regulation against COVID-19. Hence, we carried out a systematic review and meta-analysis in order to maximize the use of everything that exists about the role of vitamin D in the COVID-19.MethodsA systematic search was performed in PubMed, Scopus, Embase, Cochrane Library, Web of Science, and Google Scholar (intitle) as well as preprint database of medRxiv, bioRxiv, Research Square, preprints.org, and search engine of ScienceDirect up to October 10, 2020. Studies focused on the role of vitamin D in confirmed COVID-19 patients were entered into the systematic review.ResultsSixteen studies containing 4922 participants entered into the meta-analysis. The meta-analysis indicated that 48% of COVID-19 patients were suffering from vitamin D deficiency (95% CI, 29%-67%), and in 41% of patients, levels of vitamin D were insufficient (95% CI, 10%-82%). The serum 25-hydroxyvitamin D concentration was 18 ng/mL among all COVID-19 patients (95% CI, 13-24). Co-morbidities frequency in COVID-19 patients were as follows: 7.4% cancer, 27.1% chronic kidney disease, 30.4% cardiovascular diseases, 5.1% dementia, 14.5% depression/anxiety, 32.1% diabetes, 47.4% hypertension, 22.0% obesity and 17.5% respiratory diseases. Reported ethnic groups in studies were 1.0% Afro-Caribbean, 10.3% Asian, and 92.1% Caucasian.ConclusionThis study found that the mean serum 25-hydroxyvitamin D level was low in all COVID-19 patients, and most of them were suffering from vitamin D deficiency/insufficiency. The Caucasian was the dominant ethnic group, and the most frequent co-morbidities in COVID-19 patients were hypertension, cardiovascular diseases, chronic kidney disease, diabetes, obesity, and respiratory diseases, which might be affected by vitamin D deficiency directly or indirectly.


2011 ◽  
Vol 26 (2) ◽  
pp. 117-117 ◽  
Author(s):  
William B Grant ◽  
Stefan Pilz

Dawson’s recent extensive bibliographic review of the cause of death of Wolfgang Amadeus Mozart found that there were a number of hypotheses including poisoning, infection, cardiovascular disease, and renal disease and its complications. Overlooked in any of the papers hypothesizing about his death was a discussion of the likely role of very low serum 25-hydroxyvitamin D [25(OH)D] level in contributing to his untimely death.


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