Advertisement

Vitamin D in Health and Prevention of Metabolic Bone Disease

  • Michael F. Holick
Part of the Current Clinical Practice book series (CCP)

Abstract

Vitamin D is not in the strict sense a vitamin, but a hormone. Vitamin D is synthesized in the skin by the action of sunlight. Once vitamin D is formed in the skin or ingested in the diet, it journeys to the liver and kidney, where it is hydroxylated sequentially on carbons 25 and 1, respectively, to form its biologically active form 1,25-dihydroxyvitamin D (1,25[OH]2D). The major physiologic function of vitamin D is to maintain the extra-cellular and blood concentrations of calcium within the physiologic range in order to maintain cellular activities and neuromuscular function. Vitamin D is not only important for the skeletal health in healthy growing children, but this hormone is also essential for maintaining a healthy skeleton throughout our lives. Vitamin D insufficiency and deficiency are now being recognized as a major health problem for the elderly.

Keywords

Bone Mineral Density Parathyroid Gland Nonvertebral Fracture Metabolic Bone Disease Intestinal Calcium Absorption 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Holick MF. Vitamin D: new horizons for the 21st century.Am J Clin Nutr1994; 60: 619–630.PubMedGoogle Scholar
  2. 2.
    Clemens TL, Henderson SL, Adams JS, Holick MF. Increased skin pigment reduces the capacity of skin to synthesise vitamin D3.Lancet1982; 1: 74–76.CrossRefPubMedGoogle Scholar
  3. 3.
    Matsuoka LY, Ide L, Wortsman J, MacLaughlin J, Holick MF. Sunscreens suppress cutaneous vitamin D3 synthesis.J Clin Endocrinol Metab1987; 64: 1165–1168.CrossRefPubMedGoogle Scholar
  4. 4.
    Matsuoka LY, Wortsman J, Hanifan N, Holick MF. Chronic sunscreen use decreases circulating concentrations of 25-hydroxyvitamin D: a preliminary study.Arch Denn1988; 124: 1802–1804.Google Scholar
  5. 5.
    Matsuoka LY, Wortsman J, Dannenberg MJ, Hollis BW, Lu Z, Holick MF. Clothing prevents ultraviolet-B radiation-dependent photosynthesis of vitamin DJClin Endocrinol Metab1992; 75: 1099–1103.CrossRefGoogle Scholar
  6. 6.
    Webb AR, Kline L, Holick MF. Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin.J Clin Endocrinol Metab1988; 67: 373–378.CrossRefPubMedGoogle Scholar
  7. 7.
    Holick MF, Matsuoka LY, Wortsman J. Age, vitamin D, and solar ultraviolet radiation.Lancet1989; November 4: 1104, 1105.Google Scholar
  8. 8.
    Webb AR, DeCosta BR, Holick MF. Sunlight regulates the cutaneous production of vitamin D3by causing its photodegradation.J Clin Endocrinol Metab1989; 68: 882–887.CrossRefPubMedGoogle Scholar
  9. 9.
    Holick MF, Shao Q, Liu WW, Chen TC. The vitamin D content of fortified milk and infant formula.N Engl J Med1992; 326: 1178–1181.CrossRefPubMedGoogle Scholar
  10. 10.
    Chen TC, Heath H, III, Holick MF. An update on the vitamin D content of fortified milk from the United States and Canada.NEngl JMed1993; 329: 1507.CrossRefGoogle Scholar
  11. 11.
    Tanner JT, Smith J, Defibaugh P. Survey of vitamin content of fortified milk.JAssoc OffAnal Chem1988;71:607–610.Google Scholar
  12. 12.
    Holick MF. Vitamin D: photobiology, metabolism, and clinical applications. In: DeGroot L, ed.Endocrinology3rd ed. Philadelphia: W.B. Saunders, 1995, pp. 990–1013.Google Scholar
  13. 13.
    Darwish H, DeLuca HF. Vitamin D-regulated gene expression.Crit Rev Eukaryotic Gene Express1993; 3: 89–116.Google Scholar
  14. 14.
    Reichel H, Koeffler HP, Norman AW. The role of the vitamin D endocrine system in health and disease.N Engl JMed1989; 320: 981–991.CrossRefGoogle Scholar
  15. 15.
    Brown EM, Gamba G, Riccardi D. Cloning and characterization of an extracellular Cat+-sensing receptor from bovine parathyroid.Nature1993; 366: 575–580.CrossRefPubMedGoogle Scholar
  16. 16.
    Naveh-Many T, Silver J. Regulation of parathyroid hormone gene expression by hypocalcemia, hypercalcemia, and vitamin D in the rat.J Clin Invest1990; 86: 1313–1319.CrossRefPubMedGoogle Scholar
  17. 17.
    Demay MB. Hereditary defects in vitamin D metabolism and vitamin D receptor defects. In: DeGroot LJ, ed., Cahil GF Jr, Martini L, Nelson DH, consulting eds.Endocrinologyvol. 2,13th ed. Philadelphia: Saunders, 1995: pp. 1173–1178.Google Scholar
  18. 18.
    Krane S, Holick MF. Metabolic bone disease. In: Isselbacher KJ, Braunwald E, Wilson JD, eds.Harrison’s Principles of Internal Medicine13th ed. New York: McGraw-Hill, 1994, pp. 2172–2183.Google Scholar
  19. 19.
    Aaron JE, Gallagher JC, Anderson J. Frequency of osteomalacia and osteoporosis in fractures of the proximal femur.Lancet1974; 7851: 230–233.Google Scholar
  20. 20.
    Chapuy MC, Arlot M, Duboeuf F. Vitamin D3 and calcium to prevent hip fractures in elderly women.NEngl JMed1992; 327: 1637–1642.CrossRefGoogle Scholar
  21. 21.
    Doppelt SH, Neer RM, Daly M, Bourret L, Schiller A, Holick MF. Vitamin D deficiency and osteomalacia in patients with hip fractures.Orthop Trans1983; 7: 512, 513.Google Scholar
  22. 22.
    Holick MF, Krane S, Potts JR Jr. Calcium, phosphorus, and bone metabolism: calcium-regulating hormones. In: Isselbacher KJ, Braunwald E, Wilson JD, eds.Harrison ‘s Principles oflnternal Medicine13th ed. New York: McGraw-Hill, 1994, pp. 2137–2151.Google Scholar
  23. 23.
    Jacobus CH, Holick MF, Shao Q, Chen T, Holm IA, Kolodney JM, El-Hajj Fuleihan G, Seely E. Hypervitaminosis D associated with drinking milk.N Engl JMed1992; 326: 1173–1177.CrossRefGoogle Scholar
  24. 24.
    Rosen CJ, Morrison A, Zhou H, Storm H, Hunter S, Musgrave K, Chen T, Wen-Wei L, Holick MF. Elderly women in northern New England exhibit seasonal changes in bone mineral density and calciotropic hormones.Bone Miner1994; 25: 83–92.CrossRefPubMedGoogle Scholar
  25. 25.
    Lips, Wiersinga A, van Ginkel FC. The effect of vitamin D supplementation on vitamin D status and parathyroid function in elderly subjects.J Clin Endocrinol Metab1988; 67: 644–650.CrossRefPubMedGoogle Scholar
  26. 26.
    Krall E, Sahyoun N, Tannenbaum S, Dallal G, Dawson-Hughes B. Effect of vitamin D intake on seasonal variations in parathyroid hormone secretion in postmenopausal women.N Engl J Med1989; 321: 1777–1783.CrossRefPubMedGoogle Scholar
  27. 27.
    Potts JT Jr. Diseases of the parathyroid gland and other hyper-and hypocalcemic disorders. In: Isselbacher KJ, Braunwald E, Wilson JD, eds.Harrison’s Principles of Internal Medicine13th ed. New York: McGraw-Hill, 1994, pp. 2151–2172.Google Scholar
  28. 28.
    Slovik DM, Adams JS, Neer RM, Holick MF, Potts JT. Deficient production of 1,25-dihydroxyvitamin D in elderly osteoporotic patients.NEngl JMed1981; 305: 372–374.CrossRefGoogle Scholar
  29. 29.
    Riggs BL, Hamstra A, DeLuca HF. Assessment of 25-hydroxyvitamin D la-hydroxylase reserve in postmenopausal osteoporosis by administration of parathyroid extract.J Clin Endocrinol Metab1981; 53: 833–835.CrossRefPubMedGoogle Scholar
  30. 30.
    Bengoa JM, Sitrin MD, Meredith S. Intestinal calcium absorption and vitamin D status in chronic cholestatic liver disease.Hepatology1984; 4: 261–265.CrossRefPubMedGoogle Scholar
  31. 31.
    PietrekJ, Kokot F. Serum 25-hydroxyvitamin D in patients with chronic renal disease.EurJClin Invest1977; 7: 283–287.Google Scholar
  32. 32.
    Reid IR, Gallagher DJA, Bosworth J. Prophylaxis against vitamin D deficiency in the elderly by regular sunlight exposure.Age Ageing1985; 15: 35–40.CrossRefGoogle Scholar
  33. 33.
    Lund B, Sorensen OH. Measurement of 25-hydroxyvitamin D in serum and its relation to sunshine, age and vitamin D intake in the Danish population.Scand J Clin Lab Invest1979; 39: 23–30.CrossRefPubMedGoogle Scholar
  34. 34.
    Food and Nutrition Board. Recommended dietary allowances. In: Anonymous Subcommittee on the tenth edition of the RDAs. Washington, DC: National Academy Press, 1989, pp. 92–99.Google Scholar
  35. 35.
    Dawson-Hughes B, Dallai GE, Krall EA, Harris S, Sokoll LJ, Falconer G. Effect of vitamin D supplementation on wintertime and overall bone loss in healthy postmenopausal women.Ann Int Med1991; 115: 505–512.PubMedGoogle Scholar
  36. 36.
    Heikinheimo RJ, Ubjivaaram JA, Jantti PO, Maki-Jokela PL, Rajala SA, Sievanen H. Intermittent parenteral vitamin D supplementation in the elderly in nutritional aspects of osteoporosis. In: Burckhard P, Heaney RP, eds.Challenges of Modern Medicine.Rome, Italy: Ares-Serono Symp. Pubi, 1994, pp. 335–340.Google Scholar
  37. 37.
    Tilyard MW, Spears GFS, Thomson J, Dovey S. Treatment of postmenopausal osteoporosis with calcitriol or calcium.NEngl JMed1992; 326: 357–362.CrossRefGoogle Scholar
  38. 38.
    Ireland P, Fordtran JS. Effect of dietary calcium and age on jejunal calcium absorption in humans studied by intestinal perfusion.J Clin Invest1973; 52: 2672–2681.CrossRefPubMedGoogle Scholar
  39. 39.
    Ebeling PR, Sandgren ME, DiMagno EP, Lane AW, DeLuca HF, Riggs BL. Evidence of an age-related decrease in intestinal responsiveness to vitamin D: relationship between serum 1,25-dihydroxyvitamin D3 and intestinal vitamin D receptor concentration in normal women.J Clin Endocrinol Metab1992;75:176–182.CrossRefPubMedGoogle Scholar
  40. 40.
    Sowers MR, Wallace RB, Hollis B W, Lemke JH. Parameters related to 25-OH-D levels in a population-based study of women.Am J Clin Nutr1986; 43: 621–628.PubMedGoogle Scholar
  41. 41.
    Morrison NA, Qi JC, Tokita A. Prediction of bone density from vitamin D receptor alleles.Nature1994; 367: 284–287.CrossRefPubMedGoogle Scholar
  42. 42.
    Krall EA, Parry P, Lichter JB, Dawson-Hughes B. Vitamin D receptor alleles and rates of bone loss: influences of years since menopause and calcium intake.J Bone Miner Res1995; 10: 978–984.CrossRefPubMedGoogle Scholar
  43. 43.
    Hustmyer FG, Peacock M, Hui S, Johnston CC, Christian J. Bone mineral density in relation to polymorphism at the vitamin D receptor gene locus.J Clin Invest1994; 94: 2130–2134.CrossRefPubMedGoogle Scholar
  44. 44.
    Webb AR, Pilbeam D, Hanafin N, Holick MF, A one-year study to evaluate the roles of exposure to sunlight and diet on the circulating concentrations of 25-OH-D in an elderly population in Boston.J Clin Nutr1989; 125: 1692–1697.Google Scholar

Copyright information

© Springer Science+Business Media New York 1996

Authors and Affiliations

  • Michael F. Holick

There are no affiliations available

Personalised recommendations