Vitamin D: Update 2013: From rickets prophylaxis to general preventive healthcare

Uwe Gröber, Jörg Spitz, Jörg Reichrath, Klaus Kisters, Michael F Holick, Uwe Gröber, Jörg Spitz, Jörg Reichrath, Klaus Kisters, Michael F Holick

Abstract

Vitamin D has received a lot of attention recently as a result of a meteoric rise in the number of publications showing that vitamin D plays a crucial role in a plethora of physiological functions and associating vitamin D deficiency with many acute and chronic illnesses including disorders of calcium metabolism, autoimmune diseases, some cancers, type 2 diabetes mellitus, infectious diseases and cardiovascular disease. The recent data on vitamin D from experimental, ecological, case-control, retrospective and prospective observational studies, as well as smaller intervention studies, are significant and confirm the sunshine vitamin's essential role in a variety of physiological and preventative functions. The results of these studies justify the recommendation to improve the general vitamin D status in children and adults by means of a healthy approach to sunlight exposure, consumption of foods containing vitamin D and supplementation with vitamin D preparations. In general, closer attention should therefore be paid to vitamin D deficiency in medical and pharmaceutical practice than has been the case hitherto.

Keywords: 25-hydroxyvitamin D; atopic dermatitis; autoimmune diseases; cancer; cardiovascular diseases; degenerative brain disease; diabetes mellitus; drugs; gene expression; hypertension; osteoporosis; respiratory tract infection; vitamin D; vitamin D deficiency.

Figures

https://www.ncbi.nlm.nih.gov/pmc/articles/instance/3908963/bin/de-5-331-g1.jpg
Figure 1. Vitamin D in its hormonally active form, 1α,25-dihydroxyvitamin D is not only a regulator of calcium and phosphate homeostasis, but has numerous nonskeletal functions effects. 1α,25(OH)2D manifests its diverse biological effects (endocrine, autocrine, paracrine) by binding to the vitamin D receptor (VDR) found in most body cells. It is estimated that VDR activation may regulate directly and/or indirectly more than 200 genes, including genes responsible for the regulation of cellular proliferation, differentiation, apoptosis, and angiogenesis.
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Figure 2. 25(OH)D levels are dose-dependently associated with a robust reduction in all-cause mortality in subjects with the metabolic syndrome. Metabolic Syndrome and Kaplan-Meier plot for all-cause mortality according to 25(OH)D groups in those with the metabolic syndrome. Log-rank analysis indicated a significant difference between all 25(OH)D groups (p < 0.001).
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Figure 3. Vitamin D and immune system. 1α,25(OH)2D appears to influence susceptibility to and severity of infection via multiple mechanisms via the innate and adaptive immune system.
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Figure 4. Respiratory tract infections and vitamin D: influence of vitamin D on respiratory diseases such as influenza A and asthma in schoolchildren.
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Figure 5. Vitamin D and Crohn’s disease. Twenty-four weeks supplementation with up to 5,000 IU/d vitamin D3 effectively raised serum 25(OH)D3 and reduced CDAI scores in a small cohort of Crohn’s patients suggesting that restoration of normal vitamin D serum levels may be useful in the management of patients with mild–moderate Crohn’s disease.

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Source: PubMed

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