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Maturitas Mar 2023There is increasing evidence that vitamin D has widespread tissue effects. In addition to osteoporosis, vitamin D deficiency has been associated with cardiovascular... (Review)
Review
INTRODUCTION
There is increasing evidence that vitamin D has widespread tissue effects. In addition to osteoporosis, vitamin D deficiency has been associated with cardiovascular disease, diabetes, cancer, infections and neurodegenerative disease. However, the effect of vitamin D supplementation on non-skeletal outcomes requires clarification, especially in postmenopausal women.
AIM
This position statement provides an evidence-based overview of the role of vitamin D in the health of postmenopausal women based on observational and interventional studies.
MATERIALS AND METHODS
Literature review and consensus of expert opinion.
RESULTS AND CONCLUSIONS
Vitamin D status is determined by measuring serum 25-hydroxyvitamin D levels. Concentrations <20 ng/ml (<50 nmol/l) and <10 ng/ml (<25 nmol/l) are considered to constitute vitamin D deficiency and severe deficiency, respectively. Observational data suggest an association between vitamin D deficiency and adverse health outcomes in postmenopausal women, although they cannot establish causality. The evidence from randomized controlled trials concerning vitamin D supplementation is not robust, since many studies did not consider whether people were deficient at baseline. Moreover, high heterogeneity exists in terms of the population studied, vitamin D dosage, calcium co-administration and duration of intervention. Concerning skeletal health, vitamin D deficiency is associated with low bone mass and an increased risk of fractures. Vitamin D supplementation at maintenance doses of 800-2000 IU/day (20-50 μg/day), after repletion of vitamin D status with higher weekly or daily doses, may be of benefit only when co-administered with calcium (1000-1200 mg/day), especially in the elderly populations and those with severe vitamin D deficiency. Concerning cardiovascular disease, vitamin D deficiency is associated with an increased prevalence of cardiovascular risk factors, mainly metabolic syndrome, type 2 diabetes mellitus and dyslipidemia. Vitamin D deficiency, especially its severe form, is associated with an increased risk of cardiovascular events (coronary heart disease, stroke, mortality), independently of traditional risk factors. Vitamin D supplementation may have a modestly beneficial effect on lipid profile and glucose homeostasis, especially in obese individuals or those ≥60 years old and at doses of ≥2000 IU/day (≥50 μg/day). However, it has no effect on the incidence of cardiovascular events. Concerning cancer, vitamin D deficiency is associated with increased incidence of and mortality from several types of cancer, such as colorectal, lung and breast cancer. However, the data on other types of gynecological cancer are inconsistent. Vitamin D supplementation has no effect on cancer incidence, although a modest reduction in cancer-related mortality has been observed. Concerning infections, vitamin D deficiency has been associated with acute respiratory tract infections, including coronavirus disease 2019 (COVID-19). Vitamin D supplementation may decrease the risk of acute respiratory tract infections and the severity of COVID-19 (not the risk of infection). Concerning menopausal symptomatology, vitamin D deficiency may have a negative impact on some aspects, such as sleep disturbances, depression, sexual function and joint pains. However, vitamin D supplementation has no effect on these, except for vulvovaginal atrophy, at relatively high doses, i.e., 40,000-60,000 IU/week (1000-1500 IU/week) orally or 1000 IU/day (25 μg/day) as a vaginal suppository.
Topics: Aged; Female; Humans; Calcium; Calcium, Dietary; Cardiovascular Diseases; COVID-19; Diabetes Mellitus, Type 2; Dietary Supplements; Menopause; Neoplasms; Neurodegenerative Diseases; Vitamin D; Vitamin D Deficiency
PubMed: 36566517
DOI: 10.1016/j.maturitas.2022.12.006 -
Current Hypertension Reports Jul 2020Vitamin D and its derivatives are biologically active fat-soluble steroid hormones, which are transcription factors for numerous genes. The results of several... (Review)
Review
PURPOSE OF REVIEW
Vitamin D and its derivatives are biologically active fat-soluble steroid hormones, which are transcription factors for numerous genes. The results of several observational studies suggest the relationship between plasma concentration of vitamin D and the risk of arterial hypertension, as well as between the intensity of insolation and the risk of arterial hypertension.
RECENT FINDINGS
Based on the results of the abovementioned studies, it was hypothesized that vitamin D is characterized by the antihypertensive properties. Animal experiments have shown that vitamin D reduces activity of the renin-angiotensin-aldosterone system and improves vasorelaxation of blood vessels. Results of clinical studies did not confirm these results. Moreover in interventional clinical trials, it was documented that supplementation of vitamin D did not reduce blood pressure. The influence of exposure to sunshine at different wave lengths on blood pressure was examined in clinical studies and it was found that ultraviolet A radiation (UVA) lead to the release of nitric oxide from the skin. This might explain lower level of blood pressure in subjects from the regions with a higher rate of insolation. The aim of this review is to summarize current knowledge concerning the relationship between vitamin D and arterial hypertension based on both observational and interventional studies.
Topics: Animals; Blood Pressure; Humans; Hypertension; Renin-Angiotensin System; Vitamin D; Vitamin D Deficiency
PubMed: 32671631
DOI: 10.1007/s11906-020-01059-9 -
Nutrients Aug 2023Studies indicate a high prevalence of vitamin D deficiency in both the general population and at-risk groups. Given the association between vitamin D deficiency and... (Review)
Review
INTRODUCTION
Studies indicate a high prevalence of vitamin D deficiency in both the general population and at-risk groups. Given the association between vitamin D deficiency and various diseases, addressing this concern becomes crucial, especially in situations where routine monitoring is challenging.
MATERIALS AND METHODS
A systematic literature review of the current knowledge on vitamin D dosing in diverse at-risk populations and the application of the findings to a broader clinical perspective.
RESULTS
The reviewed studies revealed a high prevalence of vitamin D deficiency among patients with musculoskeletal disorders, systemic connective tissue diseases, corticosteroid use, endocrine and metabolic conditions, malabsorption syndromes, obesity, chronic kidney disease, cancer, and central nervous system diseases. Vitamin D deficiency was often more severe compared to the general population. Higher dosages of vitamin D beyond the recommended levels for the general population were shown to be effective in improving vitamin D status in these at-risk individuals. Additionally, some studies suggested a potential link between intermittent vitamin D administration and improved adherence.
CONCLUSION
Simplified dosing could empower clinicians to address vitamin D deficiency, particularly in high-risk populations, even without routine monitoring. Further research is needed to establish the optimal dosing regimens for specific at-risk populations.
Topics: Humans; Vitamin D; Vitamins; Vitamin D Deficiency; Knowledge; Malabsorption Syndromes
PubMed: 37686757
DOI: 10.3390/nu15173725 -
Cleveland Clinic Journal of Medicine Mar 2022Vitamin D supplementation is common in the United States, with about one-fifth of the adult population taking a daily supplement in one form or another. Although the... (Review)
Review
Vitamin D supplementation is common in the United States, with about one-fifth of the adult population taking a daily supplement in one form or another. Although the detrimental effects of insufficient sun exposure in childhood was established centuries ago, the beneficial effects of vitamin D sufficiency have only recently been established, given the myriad investigations associating vitamin D deficiency with numerous chronic diseases. But it is far less clear precisely how to replete low 25-hydroxyvitamin D (25[OH]D) levels, how long treatment should be continued, if there are potential hazards in doing so, and how to assess and counsel patients regarding the use of vitamin D. This article provides a brief historical review, examines how to assess and counsel patients on the use of vitamin D, presents scenarios that clinicians are likely to encounter, and reviews the literature on recommendations for vitamin D supplementation.
Topics: Adult; Dietary Supplements; Humans; Vitamin D; Vitamin D Deficiency; Vitamins
PubMed: 35232828
DOI: 10.3949/ccjm.89a.21021 -
Frontiers in Endocrinology 2020
Topics: Diabetes Mellitus, Type 2; Diagnostic Techniques, Endocrine; Humans; Reference Values; Vitamin D; Vitamin D Deficiency; Vitamin D-Binding Protein
PubMed: 32117066
DOI: 10.3389/fendo.2020.00040 -
Nutrients May 2023: Oral cancer is a serious health problem with an increasing incidence worldwide. Researchers have studied the potential anti-cancerous action of vitamin D and its... (Review)
Review
: Oral cancer is a serious health problem with an increasing incidence worldwide. Researchers have studied the potential anti-cancerous action of vitamin D and its association with several cancers including oral cancer. The purpose of this scoping review is to synthesize the existing literature on the role of vitamin D on oral cancer. A scoping review of the literature was conducted using the framework developed by Arkey and O'Malley and the PRISMA-ScR guidelines. Nine databases were searched for peer-reviewed human studies published in English that either investigated the association of vitamin D with, or its impact on either the prevention or treatment of oral cancer. The authors then extracted data using a predefined form to summarize information about article type, study design, participant characteristics, interventions, and outcomes. : Fifteen articles met the review criteria. Among the 15 studies, 11 were case-control, 3 were cohort studies, and 1 was a clinical trial. In four studies, the evidence supported a preventive action of vitamin D against oral cancer and a reduction in the negative side effects associated with chemo- and radiotherapy. Several studies that focused on genetic polymorphisms and the expression of the 1,25 dihydroxyvitamin D3 receptor (VDR) suggested significant associations with vitamin D and increased oral cancer risk and worse survival rates. In contrast, two studies did not reveal a strong association between vitamin D and oral cancer. : The current evidence suggests an association between vitamin D deficiency and an increased risk of oral cancer. VDR gene polymorphisms might also be a part of future preventive and therapeutic strategies against oral cancer. Carefully designed studies are required to explore and define what role, if any, vitamin D might play in the prevention and treatment of oral cancer.
Topics: Humans; Cohort Studies; Mouth Neoplasms; Vitamin D; Vitamin D Deficiency; Vitamins
PubMed: 37242229
DOI: 10.3390/nu15102346 -
Praxis Feb 2021Vitamin D Deficiency in Sports A deficiency in vitamin D is very common in the general population as well as in athletes. The aim of this overview is to assess the...
Vitamin D Deficiency in Sports A deficiency in vitamin D is very common in the general population as well as in athletes. The aim of this overview is to assess the level of knowledge about the importance of vitamin D for athletes. A deficiency in vitamin D is present in up to 90 % of athletes. Risk groups are young athletes, female athletes, athletes with a limitation such as paraplegia, vegetarians, athletes with a resorption disorder such as celiac disease, athletes training and competing indoors (e.g. ice hockey, basketball, boxing, rhythmic gymnastics), and older athletes. Dark skin pigmentation, the use of sunscreen, the time of day of the training (early morning, late evening) and the geographical location influence the risk for a deficiency in vitamin D. Exposure to the sun and a balanced diet are often not enough to prevent a vitamin D deficiency.
Topics: Athletes; Female; Humans; Sports; Sunscreening Agents; Vitamin D; Vitamin D Deficiency
PubMed: 33530783
DOI: 10.1024/1661-8157/a003550 -
JAAPA : Official Journal of the... Nov 2023Nutritional rickets is the failure of normal bone formation in children, caused by vitamin D deficiency, low calcium intake, or a combination of both. In the United...
Nutritional rickets is the failure of normal bone formation in children, caused by vitamin D deficiency, low calcium intake, or a combination of both. In the United States, prolonged breastfeeding without vitamin D supplementation is a major risk factor. Increasing awareness of the rationale for and importance of vitamin D supplements for all breastfed infants and children should reduce the incidence of vitamin D deficiency rickets and prevent bone deformity.
Topics: Infant; Female; Child, Preschool; Humans; Rickets; Vitamin D Deficiency; Vitamin D; Breast Feeding; Dietary Supplements; Calcium
PubMed: 37884036
DOI: 10.1097/01.JAA.0000977680.82301.e2 -
Polski Merkuriusz Lekarski : Organ... Sep 2019It is probably that vitamin D may play an important role in the pathogenesis of Hashimoto's disease. Previous studies have shown a higher incidence of vitamin D... (Review)
Review
It is probably that vitamin D may play an important role in the pathogenesis of Hashimoto's disease. Previous studies have shown a higher incidence of vitamin D deficiencies in patients with Hashimoto's disease compared to healthy subjects. Probably the severity of Hashimoto's disease may affect serum 25-hydroxycholecalciferol (25(OH)D) concentrations. In addition, a negative correlation between serum 25(OH)D concentrations and the level of antithyroid antibodies was observed. Moreover, vitamin D supplementation seems to be effective in reducing the levels of thyroid peroxidase (TPO) antibodies both in patients with deficiency and with normal concentrations of vitamin D. However, further studies are needed to more accurately determine the effect of vitamin D supplementation on the Hashimoto's disease.
Topics: Hashimoto Disease; Humans; Vitamin D; Vitamin D Deficiency; Vitamins
PubMed: 31557141
DOI: No ID Found -
Current Opinion in Endocrinology,... Dec 2019We review the recent literature on the interplay between mild vitamin D deficiency and skeletal muscle strength and performance. (Review)
Review
PURPOSE OF REVIEW
We review the recent literature on the interplay between mild vitamin D deficiency and skeletal muscle strength and performance.
RECENT FINDINGS
Preclinical studies indicate that vitamin D is important in muscle proliferation, differentiation and mitochondrial function, whereas some epidemiological studies demonstrate associations with muscle strength and low physical performance. Recent studies have implicated vitamin D deficiency in the development of frailty and sarcopenia in the older population. Some small studies have assessed its impact on muscle function in special circumstances such as elite sport and critical illness. Advances in liquid chromatography/mass spectrometry technologies have allowed the inter-relationships between the vitamin D metabolome and muscle phenotype to be characterized. There is evidence of distinct effects on human skeletal muscle gene expression between vitamin D metabolites.
SUMMARY
Large-scale clinical trials with well defined cohorts and outcomes are needed to provide clinically meaningful insights into this area. Care should be taken to stratify participants by vitamin D status at baseline and over follow-up in addition to observing a range of measures of muscle function.
Topics: Animals; Humans; Muscle Strength; Muscle, Skeletal; Sarcopenia; Vitamin D; Vitamin D Deficiency
PubMed: 31574001
DOI: 10.1097/MED.0000000000000504