Vitamin D and chronic diseases: the current state of the art

Abstract

The objective was to provide the current state of the art regarding the role of vitamin D in chronic diseases (osteoporosis, cancer, cardiovascular diseases, dementia, autism, type 1 and type 2 diabetes mellitus, male and female fertility). The document was drawn up by panelists that provided their contribution according to their own scientific expertise. Each scientific expert supplied a first draft manuscript on a specific aspect of the document's topic that was subjected to voting by all experts as "yes" (agreement with the content and/or wording) or "no" (disagreement). The adopted rule was that statements supported by ≥75 % of votes would be immediately accepted, while those with <25 % would be rejected outright. Others would be subjected to further discussion and subsequent voting, where ≥67 % support or, in an eventual third round, a majority of ≥50 % would be needed. This document finds that the current evidence support a role for vitamin D in bone health but not in other health conditions. However, subjects with vitamin D deficiency have been found to be at high risk of developing chronic diseases. Therefore, although at the present time there is not sufficient evidence to recommend vitamin D supplementation as treatment of chronic diseases, the treatment of vitamin D deficiency should be desiderable in order to reduce the risk of developing chronic diseases.

The Role of Vitamin D in the Immune System as a Pro-survival Molecule

“…The wide pleiotropism of this natural hormone vitamin, which can be considered similar to other diet-derived plant polyphenols, antioxidants, and additional nutritional supplements, 1 is disconcerting, compared with the high frequency of deficient levels of circulating vitamin D in the human population. [2][3][4][5] Despite its importance, people seem to live perfectly with apparently long-lasting deficiencies of vitamin D. Vitamin D is an ancient hormonal molecule; it is photosynthesized in all forms of life, starting from the phytoplankton ( 750 million years ago) to mammals and humans. 6 For certain aspects, vitamin D might be selected as one of the first natural antioxidant prohormones from nonplant-derived foods, and thus cells were instructed to synthesize it.…”

Safety and Efficacy of Weekly 30,000 IU Vitamin D Supplementation as a Slower Loading Dose Administration Compared to a Daily Maintenance Schedule in Deficient Patients: A Randomized, Controlled Clinical Trial

“…The maintenance of adequate 25-hydroxy vitamin D (25OHD) levels in the blood is required since it is essential for a large number of physiologic mechanisms beyond the classic actions in calcium homeostasis. The new role of vitamin D as a pro-hormone is rather focusing on other areas and it is also widening range of therapeutic applications in prevention and maintenance of endocrine health [7,8].…”

“…Over the past decade the daily dosing targets have been elevated from 600 IU/d to 1500-2000 IU/d and considered blood 25OHD concentration as a clinically important surrogate outcome that correlates with health and disease [8][9][10][11][12].…”

Association of Bone Metabolic Markers With Diabetic Retinopathy and Diabetic Macular Edema in Elderly Chinese Individuals With Type 2 Diabetes Mellitus

“…On the other hand, accumulating evidence has also demonstrated that the bone is an endocrine regulator of energy metabolism. For example, osteocalcin hormone secreted by the osteoblasts is a key regulator of glucose and fat metabolism [14, 15]. Despite the interrelationship between bone metabolism and the risk of diabetes, few studies have been conducted to identify the biomarkers of bone metabolism that may be associated with DR or DME.…”