VITAMIN D DEFICIENCY AND THE CLINICAL CONSEQUENCES
Abstract
Vitamin D is important for good health, growth and strong bones. Vitamin D is mostly made in the skin by exposure to sunlight. Most foods contain very little vitamin D naturally, though some are fortified with added vitamin D. Hypovitaminosis D is associated with cardiovascular disease, the metabolic syndrome, type 2 diabetes mellitus, cancer as well as with increased mortality. Further, Vitamin D deficiency is related to depression and impaired cognitive function. Increasing age and elevated body fat mass contribute to an increased risk of Vitamin D deficiency. A mild lack of vitamin D may not cause symptoms but can cause tiredness and general aches and pains. A more severe lack can cause serious problems such as rickets (in children) and osteomalacia in adults). During menopause, the decline of estrogens results in increased bone turnover, a decrease in bone mineral density and elevated fracture risk. Treatment is with vitamin D supplements. Some people are more at risk of vitamin D deficiency, and so are recommended to take vitamin D supplements routinely. These include all pregnant and breastfeeding women, all infants (babies) and young children aged 6 months to 5 years, people aged 65 and over, and people who are not exposed to much sun. There are precise recommendations regarding a sufficient Vitamin D intake in order to prevent bone loss in peri- and postmenopausal women. It is also recommend routine supplements for certain people with darker skin, and for people with certain gut, liver or kidney diseases.
References
2. Hossein-nezhad A, Holick MF. Optimize dietary intake of vitamin D: an epigenetic perspective. Curr Opin Clin Nutr Metab Care. 2012; 15: 567-579.
3. Vieth R: Why ''vitamin D'' is not a hormone, and not a synonym for 1,25 dihydroxy-vitamin D, its analogs or deltanoids. J Steroid Biochem Mol Biol. 2004; 89-90: 571-573.
4. Nagpal S, Na S, Rathnachalam R. Noncalcemic actions of vitamin D receptor ligands. Endocr Rev. 2005; 26(5): 662-687.
5. DeLuca HF: Overview of general physiologic features and functions of vitamin D. Am J Clin Nutr. 2004; 80: 1689S-1696S.
6. Bischoff-Ferari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation optimal serum concentration of 25hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr. 2006; 84(1): 18-28.
7. Holick MF. Vitamin D deficiency. N Engl J Med. 2007; 357(3): 266-281.
8. Adams JS, Hewison M. Update in vitamin D. J Clin Endocrinol Metab. 2010; 95(2): 471-478.
9. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011; 96(7): 1911-1930.
10. Rizzoli R, Boonen S, Brandi ML, et al. Vitamin D supplementation in elderly or postmenopausal women: a 2013 update of the 2008 recommendations from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Curr Med Res Opin. 2013; 29(4): 305-313.
11. Lu Z, Chen TC, Kline L, Markestad T, Pettifor J, Ladizesky M, Mautalen C, Holick MF: Photosyn-thesis of previtamin D3 in cities around the world. In: Biologic effects of light. Edited by Holick MF, Kligman A. Symposium proceedings, October 13-15:1991. Berlin: Walter De Gruyter & Company; 1992:48-51.
12. Zhang R, NaughtonD.P Vitamin D in health and disease: Current perspectives. Nutr J. 2010; 9: 65-72.
13. Arash Hossein-nezhad, MD, PhD, and Michael F. Holick, PhD, MD Vitamin D for Health: A Global Perspective Mayo Clin Proc. 2013; 88(7): 720-755.
14. Galesanu C, Florescu A, Ungureanu MC, Grozavu I, Loghin A, Ungureanu D .Vitamin D status in patients admitted in a clinic of endocrinology. Rev Med Chir Soc Med Nat Iaşi.2014; 118(2): 327-332.
15. Găleșanu C, Găleșanu MR, Moisii L. Valorile normale ale conținutului mineral osos determinate prin computertomografie cantitativă(QCT) la populația din Moldova. Rev Med Chir Soc Med Nat Iaşi. 2004: 108(2): 314-318.
16. Bolland MJ, Grey A, Gamble GD, Reid IR. Calcium and vitamin D supplements and health outcomes: a reanalysis of the Women's Health Initiative (WHI) limited access data set. Am J Clin Nutr. 2011; 94(4): 1144-1149.
17. Cigolini M, Iagulli MP, Miconi V, Galiotto M, Lombardi S, Targher G. Serum 25-hydroxyvitamin D3 concentrations and prevalence of cardiovascular disease among type 2 diabetic patients. Diab Care. 2006; 29(3): 722-724.
18. Black LJ, Seamans KM, Cashman KD, Kiely M. An updated systematic review and meta-analysis of the efficacy of vitamin D food fortification. J Nutr. 2012; 142(6): 1102-1108.
19. Mocanu V, Galesanu C, Vieth R: Bread as a Vehicle Vitamin D Fortification: Application to Nursing Home Residents. In: Handbook of Food Fortification and Health. Ed.Springer, 2013: 179-193.
20. Demetriou ET, Travison TG, Holick MF. Treatment with 50,000 IU vitamin D2 every other week and effect on serum 25-hydroxyvitamin D2, 25-hydroxyvitamin D3, and total 25-hydroxyvitamin D in a clinical setting. Endocr Pract. 2012; 18(3): 399-402.
21. Hollis BW, Wagner CL. Vitamin D and pregnancy: skeletal effects, nonskeletal effects, and birth outcomes. Calcif Tissue Int. 2013; 92(2): 128-139.
22. Hathcock JN, Shao A, Vieth R, Heaney R. Risk assessment for vitamin D. Am J Clin Nutr. 2007; 85(1): 6-18.

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