Skeletal and Extraskeletal Actions of Vitamin D: Current Evidence and Outstanding Questions.

摘要: The etiology of endemic rickets was discovered a century ago. Vitamin D is the precursor 25-hydroxyvitamin and other metabolites, including 1,25(OH)2D, ligand for vitamin receptor (VDR). effects endocrine system on bone its growth plate are primarily indirect mediated by effect intestinal calcium transport serum phosphate homeostasis. Rickets osteomalacia can be prevented daily supplements 400 IU D. deficiency (serum <50 nmol/L) accelerates turnover, loss, osteoporotic fractures. These risks reduced 800 together with an appropriate intake, given to institutionalized or D-deficient elderly subjects. VDR metabolic enzymes widely expressed. Numerous genetic, molecular, cellular, animal studies strongly suggest that signaling has many extraskeletal effects. include regulation cell proliferation, immune muscle function, skin differentiation, reproduction, as well vascular properties. From observational in human subjects, poor status associated nearly all diseases predicted these actions. Results randomized controlled trials Mendelian randomization supportive supplementation reducing incidence some diseases, but, globally, conclusions mixed. findings point need continued ongoing future basic clinical better define whether optimized improve aspects health. enhances risk fractures diseases. We review what established plausible regarding health