Objective: The central role of vitamin D in bone health is well recognized. However, controversies regarding its clinical application remain. We therefore aimed to review the definition of hypovitaminosis D, the skeletal and extra-skeletal effects of vitamin D and the available therapeutic modalities. Design: Narrative and systematic literature review. Methods: An international working group that reviewed the current evidence linking bone and extra-skeletal health and vitamin D therapy to identify knowledge gaps for future research. Results: Findings from observational studies and randomized controlled trials (RCTs) in vitamin D deficiency are discordant, with findings of RCTs being largely negative. This may be due to reverse causality with the illness itself contributing to low vitamin D levels. The results of many RCTs have also been inconsistent. However, overall evidence from RCTs shows vitamin D reduces fractures (when administered with calcium) in the institutionalized elderly. Although controversial, vitamin D reduces acute respiratory tract infections (if not given as bolus monthly or annual doses) and may reduce falls in those with the lowest serum 25-hydroxyvitamin D (25OHD) levels. However, despite large ongoing RCTs with 21 000-26 000 participants not recruiting based on baseline 25OHD levels, they will contain a large subset of participants with vitamin D deficiency and are adequately powered to meet their primary end-points. Conclusions: The effects of long-term vitamin D supplementation on non-skeletal outcomes, such as type 2 diabetes mellitus (T2DM), cancer and cardiovascular disease (CVD) and the optimal dose and serum 25OHD level that balances extra-skeletal benefits (T2DM) vs risks (e.g. CVD), may soon be determined by data from large RCTs.
Management of endocrine disease: Therapeutics of Vitamin D / Ebeling, P. R.; Adler, R. A.; Jones, G.; Liberman, U. A.; Mazziotti, G.; Minisola, S.; Munns, C. F.; Napoli, N.; Pittas, A. G.; Giustina, A.; Bilezikian, J. P.; Rizzoli, R.. - In: EUROPEAN JOURNAL OF ENDOCRINOLOGY. - ISSN 0804-4643. - 179:5(2018), pp. R239-R259.
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|Titolo:||Management of endocrine disease: Therapeutics of Vitamin D|
MINISOLA, Salvatore [Writing – Review & Editing]
|Data di pubblicazione:||2018|
|Citazione:||Management of endocrine disease: Therapeutics of Vitamin D / Ebeling, P. R.; Adler, R. A.; Jones, G.; Liberman, U. A.; Mazziotti, G.; Minisola, S.; Munns, C. F.; Napoli, N.; Pittas, A. G.; Giustina, A.; Bilezikian, J. P.; Rizzoli, R.. - In: EUROPEAN JOURNAL OF ENDOCRINOLOGY. - ISSN 0804-4643. - 179:5(2018), pp. R239-R259.|
|Appartiene alla tipologia:||01a Articolo in rivista|