Controversies in Vitamin D: Summary Statement From an International Conference

Abstract

Context Vitamin D is classically recognized as a regulator of calcium and phosphorus metabolism. Recent advances in the measurement of vitamin D metabolites, diagnosis of vitamin D deficiency, and clinical observations have led to an appreciation that along with its role in skeletal metabolism, vitamin D may well have an important role in nonclassical settings. Measurement of the circulating form of vitamin D that best describes total body stores, namely 25-hydroxyvitamin D, can be unreliable despite many sophisticated methodologies that have been proposed and implemented. Likewise, evidence from clinical studies showing a beneficial role of vitamin D in different disease states has been controversial and at times speculative. Moreover, the target concentrations of 25-hydroxyvitamin D to address a number of putative links between vitamin D inadequacy and nonskeletal diseases are further areas of uncertainty. Setting To address these issues, an international conference on “Controversies in Vitamin D” was held in Pisa, Italy, in June 2017. Three main topics were addressed: (i) vitamin D assays and the definition of hypovitaminosis D; (ii) skeletal and extraskeletal effects of vitamin D; (iii) therapeutics of vitamin D. Results This report provides a summary of the deliberations of the expert panels of the conference. Conclusions Despite great advances in our appreciation of vitamin D metabolism, measurements, biological actions on classical and nonclassical tissues, and therapeutics, all of which this report summarizes, much more work remains to be done so that our knowledge base can become even more secure.

Evidence Supports a Causal Model for Vitamin D in COVID-19 Outcomes

“…A causal inference framework has a great deal of value to add beyond the current pandemic. Vitamin D has received a great deal of renewed attention in recent years, but a beneficial role for it in disease states has been controversial [68]. Vitamin D deficiency is association with many serious diseases has raised the question of whether it is a bystander, simply a general marker of illheath, or plays an active role in the cause and progression of diseases.…”

Association of Differing Qatari Genotypes with Vitamin D Metabolites

“…However, given the whole body coverage that is prevalent in the Middle East [7], then that is likely to be the prevailing and dominant factor in this instance rather than skin pigmentation. Vitamin D in the form of 25(OH)D is measured to ascertain vitamin D sufficiency [30] with the other metabolites being largely measured for research purposes [30]. In this case, 1,25(OH)2D levels significantly differed between Q2 and the admixed groups, perhaps through increased renal or extrarenal CYP27B1 activity, whilst 24,25(OH)2D significantly differed between Q1 and the admixed groups, perhaps through modulation of CYP27A1 activity.…”

Vitamina D e insuficiencia cardíaca. Fisiopatología, prevalencia, y asociación pronóstica

“…Although there is no consensus on the optimal levels of vitamin D, the deficiency of this hormone is defined by most experts as a level of 25-hydroxy-cholecalciferol (25-HCC) below 20 ng/ml 4,[38][39][40][41][42] . To be more specific, according to the consensus uniformly accepted by scientific societies dedicated to bone mineral metabolism, patients are considered to have optimal levels of vitamin D when serum 25-HCC levels are above 30 ng/ml; between 29 and 20 ng/ml it is considered that there is an insufficiency; and below 20 ng/ml the existence of a deficiency is established, which would be severe with 25-HCC figures below 10 ng/ml 38,41 .…”