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5 Vitamin D questions for 7 experts – Jan 2024

A view on vitamin D: a pleiotropic factor?

ANat Rev Endocrinol . 2024 Jan 22. doi: 10.1038/s41574-023-00942-0
Andrea Giustina 1 2,
Marise Lazaretti-Castro 3,
Adrian R Martineau 4,
Rebecca S Mason 5,
Clifford J Rosen 6,
Inez Schoenmakers 7

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  1. In your opinion, what are the key roles of vitamin D in physiology?
  2. How does low vitamin D?
  3. How does low vitamin D affect health outcome?
  4. Should vitamin D levels ever be monitored, and people be given supplements if levels are low?
    If supplements are taken, what would be the ideal dose?
  5. What are the research gaps and how can the vitamin D field move forward?

  1. Moreira, C. A. et al. Reference values of 25-hydroxyvitamin D revisited: a position statement from the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Society of Clinical Pathology/Laboratory Medicine (SBPC). Arch. Endocrinol. Metab. 64, 462–478 (2020). - PubMed - PMC
  2. Bouillon, R. et al. Vitamin D and human health: lessons from the VDR receptor null mice. Endocr. Rev. 29, 726–776 (2008). - DOI - PubMed - PMC
  3. De Silva, W. G. M. et al. Evidence for involvement of nonclassical pathways in the protection from UV-induced DNA damage by vitamin D-related compounds. JBMR Plus 5, e10555 (2021). - DOI - PubMed - PMC
  4. Maretzke, F. et al. Role of vitamin D in preventing and treating selected extraskeletal diseases – an umbrella review. Nutrients 12, 969 (2020). - DOI - PubMed - PMC
  5. Bilezikian, J. P. et al. Vitamin D: dosing, levels, form, and route of administration: does one approach fit all? Rev. Endocr. Metab. Disord. 22, 1201–1218 (2021). - DOI - PubMed - PMC
  6. di Filippo, L. et al. Low vitamin D levels predict outcomes of COVID-19 in patients with both severe and non-severe disease at hospitalization. Endocrine 80, 669–683 (2023). - DOI - PubMed - PMC
  7. di Filippo, L. et al. Low vitamin D levels are associated with long COVID syndrome in COVID-19 survivors. J. Clin. Endocrinol. Metab. 108, e1106–e1116 (2023). - DOI - PubMed - PMC
  8. di Filippo, L. et al. Lack of vitamin D predicts impaired long-term immune response to COVID-19 vaccination. Endocrine 82, 536–541 (2023). - DOI - PubMed - PMC
  9. Jolliffe, D. A. et al. Vitamin D supplementation to prevent acute respiratory infections: a systematic review and meta-analysis of aggregate data from randomised controlled trials. Lancet Diabetes Endocrinol. 9, 276–292 (2021). - DOI - PubMed
  10. Jolliffe, D. A. et al. Vitamin D to prevent exacerbations of COPD: systematic review and meta-analysis of individual participant data from randomised controlled trials. Thorax 74, 337–345 (2019). - DOI - PubMed
  11. Middelkoop, K. et al. Vitamin D supplementation to prevent tuberculosis infection in South African schoolchildren: multicentre phase 3 double-blind randomised placebo-controlled trial (ViDiKids). Int. J. Infect. Dis. 134, 63–70 (2023). - DOI - PubMed
  12. Jolliffe, D. A. et al. Adjunctive vitamin D in tuberculosis treatment: meta-analysis of individual participant data. Eur. Respir. J. 53, 1802003 (2019). - DOI - PubMed
  13. Chakhtoura, M. et al. Vitamin D supplementation and fractures in adults: a systematic umbrella review of meta-analyses of controlled trials. J. Clin. Endocrinol. Metab. 107, 882–898 (2022). - DOI - PubMed
  14. Hahn, J. et al. Vitamin D and marine omega 3 fatty acid supplementation and incident autoimmune disease: VITAL randomized controlled trial. BMJ 376, e066452 (2022). - DOI - PubMed - PMC
  15. Keum, N., Chen, Q. Y., Lee, D. H., Manson, J. E. & Giovannucci, E. Vitamin D supplementation and total cancer incidence and mortality by daily vs. infrequent large-bolus dosing strategies: a meta-analysis of randomised controlled trials. Br. J. Cancer 127, 872–878 (2022). - DOI - PubMed - PMC
  16. Institute of Medicine. Dietary Reference Intakes for Calcium and Vitamin D (National Academies Press, 2011).
  17. LeBoff, M. S. et al. Supplemental vitamin D and incident fractures in midlife and older adults. N. Engl. J. Med 387, 299–309 (2022). - DOI - PubMed - PMC
  18. Schoenmakers, I. & Jones, K.S. in Feldman and Pike’s Vitamin D (eds Hewison, M., Bouillon, R. & Walsh, J.) 633–668 (Elsvier, 2024).
  19. Borba, V. Z. C., Lazaretti-Castro, M., Moreira, S. D. S., de Almeida, M. C. C. & Moreira, E. D. Jr. Epidemiology of vitamin D (EpiVida) – a study of vitamin D status among healthy adults in Brazil. J. Endocr. Soc. 7, bvac171 (2022). - DOI - PubMed - PMC
  20. Foroni, M. Z. et al. Serum 25 hydroxyvitamin D concentrations in individuals over 80 years old and their correlations with musculoskeletal and health parameters. Endocrine 79, 559–570 (2023). - DOI - PubMed
  21. Luxwolda, M. F., Kuipers, R. S., Kema, I. P., Dijck-Brouwer, D. A. & Muskiet, F. A. Traditionally living populations in East Africa have a mean serum 25-hydroxyvitamin D concentration of 115 nmol/l. Br. J. Nutr. 108, 1557–1561 (2012). - DOI - PubMed
  22. Chapuy, M. C. et al. Calcium and vitamin D to prevent hip fractures in elderly women. N. Engl. J. Med 327, 1637–1642 (1992). - DOI - PubMed
  23. Bouillon, R. Comparative analysis of nutritional guidelines for vitamin D. Nat. Rev. Endocrinol. 13, 466–479 (2017). - DOI - PubMed
  24. Turck, D. et al. Scientific opinion on the tolerable upper intake level for vitamin D, including the derivation of a conversion factor for calcidiol monohydrate. EFSA J. 21, e08145 (2023). - PubMed - PMC

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