The Biphasic Effect of Vitamin D on the Musculoskeletal and Cardiovascular System

Abstract

This narrative review summarizes beneficial and harmful vitamin D effects on the musculoskeletal and cardiovascular system. Special attention is paid to the dose-response relationship of vitamin D with clinical outcomes. In infants and adults, the risk of musculoskeletal diseases is highest at circulating 25-hydroxyvitamin D (25OHD) concentrations below 25 nmol/L and is low if 40–60 nmol/L are achieved. However, evidence is also accumulating that in elderly people the risk of falls and fractures increases again at circulating 25OHD levels > 100 nmol/L. Cohort studies report a progressive increase in cardiovascular disease (CVD) events at 25OHD levels < 50 nmol/L. Nevertheless, meta-analyses of randomized controlled trials suggest only small beneficial effects of vitamin D supplements on surrogate parameters of CVD risk and no reduction in CVD events. Evidence is accumulating for adverse vitamin D effects on CVD outcomes at 25OHD levels > 100 nmol/L, but the threshold may be influenced by the level of physical activity. In conclusion, dose-response relationships indicate deleterious effects on the musculoskeletal system and probably on the cardiovascular system at circulating 25OHD levels < 40–60 nmol/L and >100 nmol/L. Future studies should focus on populations with 25OHD levels < 40 nmol/L and should avoid vitamin D doses achieving 25OHD levels > 100 nmol/L.

Anthropometrics, diet, and resting energy expenditure in Norwegian adults with achondroplasia

“…There is strong evidence for a causal link between dietary patterns and CVD risk (Mente et al, ). Micronutrient status is also important, for example, vitamin D and folate have been found to play protective roles in the cardiovascular system (Lamberg‐Allardt, Brustad, Meyer, & Steingrimsdottir, ; Li et al, ; Stanhewicz & Kenney, ; Van Guelpen et al, ; Zittermann, ). The Mediterranean diet is significantly associated with a reduced risk of CVD, while the Western diet is significantly associated with increased CVD risk (Mente et al, ; Micha, Penalvo et al, ).…”

The Effect of Physical Activity on Vitamin D Status in Pregnant Women Participating in a Randomized Controlled Trial

“…Vitamin D is a fat-soluble vitamin and steroid hormone known to play a vital role in numerous physiologic processes classically involving calcium and bone metabolism, but also involving muscle, lipid and glucose metabolism [1], immune functioning [1], and the cardiovascular system [2,3]. Vitamin D is acquired in two ways: from conversion of 7-dehydrocholesterol into pre-vitamin D 3 in the skin by sunlight (ultraviolet B irradiation) or from diet or supplementation in the form of cholecalciferol (vitamin D 3 ) or ergocalciferol (vitamin D 2 ) [1,4]. These forms of vitamin D are converted to 25-hydroxyvitamin D (25(OH)D or calcidiol), the indicator of vitamin D status and the primary circulating form that is ultimately converted to the biologically active form 1,25-dihydroxycholecalciferol (1,25(OH)2D or calcitriol) [1,4].…”

“…Vitamin D is acquired in two ways: from conversion of 7-dehydrocholesterol into pre-vitamin D 3 in the skin by sunlight (ultraviolet B irradiation) or from diet or supplementation in the form of cholecalciferol (vitamin D 3 ) or ergocalciferol (vitamin D 2 ) [1,4]. These forms of vitamin D are converted to 25-hydroxyvitamin D (25(OH)D or calcidiol), the indicator of vitamin D status and the primary circulating form that is ultimately converted to the biologically active form 1,25-dihydroxycholecalciferol (1,25(OH)2D or calcitriol) [1,4]. Vitamin D concentration is affected by many factors, including diet, sunlight exposure, geographic relation to the equator, skin pigmentation, race/ethnicity, age of skin, ability to absorb fatsoluble vitamins, body mass index (BMI), and exercise [2,4].…”

“…These forms of vitamin D are converted to 25-hydroxyvitamin D (25(OH)D or calcidiol), the indicator of vitamin D status and the primary circulating form that is ultimately converted to the biologically active form 1,25-dihydroxycholecalciferol (1,25(OH)2D or calcitriol) [1,4]. Vitamin D concentration is affected by many factors, including diet, sunlight exposure, geographic relation to the equator, skin pigmentation, race/ethnicity, age of skin, ability to absorb fatsoluble vitamins, body mass index (BMI), and exercise [2,4].…”

Neuere Erkenntnisse über Vitamin D

“…Auch zur Vermeidung von Atemwegsinfekten waren Bolusgaben an Vitamin D unwirksam [6]. Hinzu kommt, dass eine hochdosierte Vitamin-D-Einnahme oder -Gabe das Risiko für Stürze und Frakturen sowie für kardiovaskuläre Ereignisse vermutlich sogar erhöht, falls hierdurch Blutspiegel an 25OHD über 40 ng/ml erzielt werden [7].…”