Reply to Wimalawansa, S.J. Comment on “Bertoldo et al. Definition, Assessment, and Management of Vitamin D Inadequacy: Suggestions, Recommendations, and Warnings from the Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS). Nutrients 2022, 14, 4148”

Abstract

With regard to Dr. Wimalawansa’s comment [...]

Osteoporosis and dermatoporosis: a review on the role of vitamin D

“…The interpretation of serum 25(OH)D has to take into account many factors, as levels can vary widely in different life periods, based on degree of exposure to sunshine (period of the year, latitude), phototype, and nutritional status (76). There is also a large variability in its dosage between different laboratories.…”

“…In fact, there is still no unanimous consensus among scientific societies for the definition of the deficiency of VD, except for the condition of serious deficiency represented by values of 25(OH)D <10 ng/mL which are linked with higher risk of rickets and osteomalacia. Since the observation that in the general population there is a relationship between values of serum 25(OH)D < 20 ng/mL and increased risk of fracture (77), the Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS) suggests to consider these cutoffs: "deficient" means a 25(OH)D level of 10 ng/mL; "insufficient" means a level of 20 ng/mL; and "optimal" means a level of 20-50 ng/mL (76). In patients with OP, especially those who necessitate a treatment with OP drugs and subjects at risk of hypovitaminosis D, an "optimal" level of at least 30 ng/mL is instead indicated.…”