How to Define Optimal Vitamin D Status

Bouillon, Roger

doi:10.1016/b978-0-12-381978-9.10058-7

Cited by 4 publications

(4 citation statements)

References 160 publications

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“…-still remain unresolved to this day. The diversity of opinions on this matter has generated strong arguments between researchers 7,8 and scientific societies. In fact the different scientific societies have proposed as cut off points for normality for vitamin D two blood levels of 25-hydroxyvitmin D: above 20 ng/ml by the Institute of Medicine 9 , and above 30 ng/ml for the International Osteoporosis Foundation (IOF) 10 , the latter supported by the recommendation of the Endocrinology Society of the US 11 and in Spain by the Spanish Society for Bone and Mineral Metabolism Research (SEIOMM) 12 .…”

Section: -Hydroxyvitamin D Marker For the Status Of Vitamin D In Tmentioning

confidence: 99%

Deficiencia de vitamina D en España: ¿realidad o mito?

Valverde

Gómez

2014

Rev Osteoporos Metab Miner

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Vitamin D 3 (colecalciferol) is formed from its precursor 7-dehydrocholesterol in the skin by ultraviolet irradiation. In the liver the vitamin D 3 is hydroxylated to form 25-hydroxyvitamin D 3 , which is metabolised to its active metabolite 1,25-dihydroxyvitamin D 3 preferentially in the kidney. Vitamin D 3 may also be provided in the diet, which is a significant source of supply only in the case of insufficient exposure to sunlight. Blue fish naturally contains large quantities of vitamin D 3 , while other foods contain significant quantities of vitamin D only after being fortified. For fortification, in many countries vitamin D 2 is used (ergocalciferol) obtained from vegetable sources 1 . The presence of the enzyme CYP27B1, which drives the synthesis of dihydroxyvitamin D from its principal substrate, 25-hydroxyvitamin D, and the vitamin D receptor (VDR), distributed almost universally in the cells and tissues of the organism, confers on vitamin D (although it would be increasingly more correct to say the endocrine system of vitamin D) a broad role in health. This is not only in the regulation of calcium and bone metabolism but also in relation to the cardiovascular system, innate or acquired immunomodulation, the regulation of cell growth, etc., such that around 3% of the human genome is regulated by the hormone 1,25(OH) 2 vitamin D 3 1-3 . It is therefore not surprising that basic scientific and clinical interest in vitamin D 4 , as well as interest in the non-specialist press and in the general population 5 , has increased almost exponentially in the last decade. 25-hydroxyvitamin D, marker for the status of vitamin D in the bodyFor some years there has been universal consensus that the measurement of the levels of the metabolite 25-hydroxyvitamin D in the blood is the marker for the status of vitamin D in the body, including the endogenous synthesis due to exposure to sunlight, dietary consumption in foods, supplemented or not, and pharmacological treatments 1,2

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Section: -Hydroxyvitamin D Marker For the Status Of Vitamin D In Tmentioning

confidence: 99%

Deficiencia de vitamina D en España: ¿realidad o mito?

Valverde

Gómez

2014

Rev Osteoporos Metab Miner

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“…Therefore, the attention of basic and clinical scientists as well as the lay press (18,19) and the general population for vitamin D has increased nearly exponentially over the last decade (6, 17, 20 -22). The essential question of how much vitamin D is needed for optimal bone and global health, however, remains unsolved (17,20,21,23,24). The diversity of opinions on this topic has created lively discussions because the conclusion based on randomized controlled trials (RCTs) differs from the conclusions based on the large body of observational studies.…”

mentioning

confidence: 99%

Optimal Vitamin D Status: A Critical Analysis on the Basis of Evidence-Based Medicine

Bouillon

Schoor

Gielen

et al. 2013

The Journal of Clinical Endocrinology &Amp; Metabolism

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243

211

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The extraskeletal effects of vitamin D are plausible as based on preclinical data and observational studies. However, apart from the beneficial effects of 800 IU/d of vitamin D3 for reduction of falls in the elderly, causality remains yet unproven in randomized controlled trials (RCTs). The greatest risk for cancer, infections, cardiovascular and metabolic diseases is associated with 25-hydroxyvitamin D (25OHD) levels below 20 ng/mL. There is ample evidence from RCTs that calcium and bone homeostasis, estimated from serum 1,25-dihydroxyvitamin D and PTH, calcium absorption, or bone mass, can be normalized by 25OHD levels above 20 ng/mL. Moreover, vitamin D supplementation (800 IU/d) in combination with calcium can reduce fracture incidence by about 20%. Such a dose will bring serum levels of 25OHD above 20 ng/mL in nearly all postmenopausal women. Based on calculations of the metabolic clearance of 25OHD, a daily intake of 500-700 IU of vitamin D3 is sufficient to maintain serum 25OHD levels of 20 ng/mL. Therefore, the recommendations for a daily intake of 1500-2000 IU/d or serum 25OHD levels of 30 ng or higher for all adults or elderly subjects, as suggested by The Endocrine Society Task Force, are premature. Fortunately, ongoing RCTs will help to guide us to solve this important public health question.

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“…Vitamin D concentration of <10 ng/mL is associated with poorest muscle function compared to a level higher than 20 ng/mL (which is associated with improved muscle strength). 29 …”

Section: Clinical Outcomes Of Vitamin D Deficiencymentioning

confidence: 99%

“…Vitamin D concentration of <10 ng/ mL is associated with poorest muscle function compared to a level higher than 20 ng/mL (which is associated with improved muscle strength). 29 Risk factors for osteomalacia are the same as in classical rickets. Etiology includes abnormal metabolism of vitamin D (from deficient intake or absorption, defective hydroxylation of cholecalciferol, loss of vitamin D binding protein, and defective 1α,25-hydroxylation), mineralization defects (from the abnormal matrix, enzyme deficiency, and inhibitors of mineralization), and phosphate deficiency (due to a decreased intake and impaired renal absorption).…”

Section: Osteomalacia and Osteomalacic Myopathymentioning

confidence: 99%

Pediatric Hypovitaminosis D

Ariganjoye¹

2017

Global Pediatric Health

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Vitamin D, a secosteroid, is essential for the development and maintenance of healthy bone in both the adult and pediatric populations. Low level of 25-hydroxy vitamin D (25-(OH)-D) is highly prevalent in children worldwide and has been linked to various adverse health outcomes including rickets, osteomalacia, osteomalacic myopathy, sarcopenia, and weakness, growth retardation, hypocalcemia, seizure and tetany, autism, cardiovascular diseases, diabetes mellitus, cancers (prostate, colon, breast), infectious diseases (viral, tuberculosis), and autoimmune diseases, such as multiple sclerosis and Hashimoto’s thyroiditis. Risk factors for hypovitaminosis D are people with darker skin pigmentation, use of sunscreen, insufficient ultraviolet B exposure, prematurity, living in northern latitudes, malnutrition, obesity, exclusive breastfeeding, low maternal vitamin D level, certain medications, drinking unfortified cow’s milk, liver failure, chronic renal insufficiency, cystic fibrosis, asthma, and sickle cell hemoglobinopathy. This review highlights and summarizes the molecular perspectives of vitamin D deficiency and its potential adverse health outcomes in pediatric age groups. The recommended treatment regimen is beyond the scope of this review.

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How to Define Optimal Vitamin D Status

Cited by 4 publications

References 160 publications

Deficiencia de vitamina D en España: ¿realidad o mito?

Deficiencia de vitamina D en España: ¿realidad o mito?

Optimal Vitamin D Status: A Critical Analysis on the Basis of Evidence-Based Medicine

Pediatric Hypovitaminosis D

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