Scand J Clin Lab Invest Suppl. 2012;243:154-62.
Brannon PM.
Cornell University , Ithaca, NY , USA.
Probably presented at the Bermeyer Coonference in Garmishpartenkirchen (Germany) in March 2012
Despite interest and expanding research on non-bone health outcomes, the evidence remains inconclusive concerning the causal role of vitamin D in the non-bone health outcomes.
To improve our understanding of its role, research needs to address five key areas related to vitamin D:
- its physiology and molecular pathways.
- its relationship to health outcomes.
- its exposure-response relationships,
- its interactions with genotype and other nutrients and
- its adverse effects.
Its metabolism needs to be elucidated including extra-renal activation and catabolism, distribution and mobilization from body pools, kinetics of this distribution, and their regulation during pregnancy and lactation.
Rigorous, well-designed randomized clinical trials need to evaluate the causal role of vitamin D in a diverse array of non-bone health and chronic disease outcomes across the life cycle and reproductive states.
Critically needed is the determination of the exposure-response, inflection and threshold of serum 25(OH)D concentrations relative to functional and health outcomes.
The dose-response relationships of standardized measures of serum 25(OH)D need to be understood in response to low and high doses of total vitamin D with careful consideration of confounding factors including catabolic rates.
How do relevant genetic polymorphisms, dietary calcium and phosphate and potentially dietary cholesterol interact with vitamin D exposure on its bioavailability, transport, distribution in body pools, metabolism and action as well as on bone and non-bone health outcomes?
The nature and mechanisms of U-shaped risk relationships with adverse health outcomes at higher exposure to vitamin D needs elucidated across the life cycle and reproductive stages.
PMID: 22536777
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