MECHANISMS IN ENDOCRINOLOGY: Vitamin D as a potential contributor in endocrine health and disease

Abstract

Objective: It has been suggested that vitamin D may play a role in the pathogenesis of several endocrine diseases, such as hyperparathyroidism, type 1 diabetes (T1DM), type 2 diabetes (T2DM), autoimmune thyroid diseases, Addison's disease and polycystic ovary syndrome (PCOS). In this review, we debate the role of vitamin D in the pathogenesis of endocrine diseases. Methods: Narrative overview of the literature synthesizing the current evidence retrieved from searches of computerized databases, hand searches and authoritative texts. Results: Evidence from basic science supports a role for vitamin D in many endocrine conditions. In humans, inverse relationships have been reported not only between blood 25-hydroxyvitamin D and parathyroid hormone concentrations but also with risk of T1DM, T2DM, and PCOS. There is less evidence for an association with Addison's disease or autoimmune thyroid disease. Vitamin D supplementation may have a role for prevention of T2DM, but the available evidence is not consistent. Conclusions: Although observational studies support a potential role of vitamin D in endocrine disease, high quality evidence from clinical trials does not exist to establish a place for vitamin D supplementation in optimizing endocrine health. Ongoing randomized controlled trials are expected to provide insights into the efficacy and safety of vitamin D in the management of endocrine disease.

Hormonal alterations in PCOS and its influence on bone metabolism

“…This hyperandrogenemia helps to preserve bone mass in PCOS women. But androgen has positive effect on bone ↑ Bone resorption Vitamin D (Muscogiuri et al 2014) 232:2 only in the presence of estrogen. Without the estradiol peak or progesterone production associated with normal menstrual cycle, there is no net positive effect for androgen on bone (Fig.…”

“…Several recent studies suggest that vitamin D is also involved in some non-skeletal actions that may lead to the pathogenesis of several endocrine diseases including PCOS (Muscogiuri et al 2014). In PCOS patients, an inverse relationship between the vitamin D status and metabolic and hormonal disturbance has been reported in PCOS (Muscogiuri et al 2014). Vitamin D influences glucose homeostasis and insulin sensitivity.…”

Concomitant autoimmune thyroiditis and primary hyperparathyroidism – random association? Two cases report

“…A correlation between AIT and reduced vitamin D action (as some polymorphisms of vitamin D receptor gene, vitamin D binding proteins, 1-and 25 hydroxylase) has also been demonstrated [16]. On the other side, type 2 deiodinase activity has been demonstrated in the mouse skeleton and is induced by vitamin D, suggesting a closer relationship between thyroid hormones and vitamin D [17].…”

Vitamin D and polycystic ovary syndrome: an integrating review

“…That the variety of phenotypes of PCOS patients and the heterogeneity of available studies make it difficult to draw conclusions and suggest the conduction of clinical trials with well-defined populations [26].…”