Vitamin D: Can Gender Medicine Have a Role?

Abstract

This narrative review aims to shed light on the role of gender differences, on the biological and molecular functions in the main pathological mechanisms that recognize the role of vitamin D. Vitamin D deficiency is widespread worldwide, but it is still very controversial whether the amount of vitamin D taken daily is actually the only problem related to its biological functions. Currently, the plasma concentration of 25-hydroxyvitamin D represents the only indicator of the circulating blood quota. The concept is that the biological function of vitamin D is not only linked to its circulating levels, but it is hypothesized that its biological functions depend, above all, on its total bioavailability. In particular, vitamin D circulates for the most part linked to albumin and vitamin D binding protein (DBP), which depend on various pathological conditions and physiologically, above all, the function of the latter is regulated by estrogens, glucocorticoids, and inflammatory cytokines. During her life, women undergo various changes in the hormonal and sexual sphere concerning menarche, possible pregnancies, and breastfeeding but also the use of contraceptives and, finally, the transition from the period of fertility to menopause. Each of these phases presents specific needs and, consequently, sometimes also specific criticalities. Studies on young women have shown that vitamin D deficiency is present in 58 to 91% of cases. Obesity, metabolic disorders, and variation in estrogen contraction may affect vitamin D deficiency due to the decreased bioavailability from dietary sources due to deposition in body fat compartments.

Gender Differences in Insulin Resistance: New Knowledge and Perspectives

“…A significant interaction between sex and vitamin D is evidenced by the fact that low levels of 25(OH) of vitamin D3 are associated with T2DM in women but not in men [71]. We have also seen how there is an interchange between vitamin D and estrogen; on the one hand, vitamin D increases the bioavailability of estrogens and, on the other, the latter is able to increase the efficiency of absorption, transport systems, and affinity with its receptor [72]. The important role of the composition of the intestinal microbiota has also been established both in promoting the production of intestinal estrogens with a systemic function and, with them, greater absorption of vitamin D [73].…”

“…In the last twenty years, tobacco consumption has increased in women, particularly young women, who therefore, having more years of exposure, will be exposed to an unpredictable risk of metabolic alterations linked to IR [70], with early mortality from cardiovascular disease also increasing in general in women [71]. The risk of developing metabolic conditions related to IR is also similar in women and men with regard to exposure to secondhand smoke [72].…”

Serum 25-Hydroxyvitamin D Level Is Positively Associated with Vascular Reactivity Index in Patients with Type 2 Diabetes Mellitus

“…Estrogen exerts considerable influence on vitamin D metabolism, particularly among women of reproductive age. Additionally, women typically exhibit higher total fat mass than men, potentially resulting in the sequestration of fat-soluble vitamin D in adipose tissue and consequently reducing the bioavailability of vitamin D3 [ 37 ]. These gender-related differences necessitate consideration in future studies investigating VRI and endothelial function.…”

Clustering Disease of Clostridioides Difficile Infection: Implication for the Management in Internal Medicine

“…While on the one hand, we find a progressive decline in the immune system, on the other, it is possible to observe an increase in the levels of pro-inflammatory cytokines [127,128]. Furthermore, with advancing, we also have an involution of the functioning of the natural barriers of our organism a decrease in the production of saliva and gastric acid secretion [129,130], and lower absorption of nutrients and essential elements for the correct functioning of the immune system such as iron and vitamin B complex, folic acid, vitamin D [131,132], largely related to the decrease in intestinal transit and the reduced enzymatic digestion and absorption of nutrients [133][134][135].…”