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Vitamin D: Biological Significance and Diagnosis of Mild Deficiency

  • Enrico CarminaEmail author
Reference work entry
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Part of the Biomarkers in Disease: Methods, Discoveries and Applications book series (BDMDA)

Abstract

Activated vitamin D has a main role in bone metabolism by increasing intestinal calcium absorption and kidney calcium resorption but also by activating both bone formation and resorption. This last effect may be mainly indirect by modulating PTH secretion. In mild forms of vitamin D deficiency, the increase in PTH secretion is probably the main factor determining bone loss.

In diagnosis of vitamin D deficiency, the establishment of a circulating vitamin D (mono or di-hydroxylated vitamin D) cutoff is particularly important but has been difficult because differences in used criteria. Based on PTH circulating levels and femoral neck bone density, a mono-hydroxylated vitamin D cutoff of 25 ng/ml may be the best criterion for distinguishing a mild vitamin D deficiency.

Vitamin D action is not limited to bone metabolism but involves modulation of immune function, stimulation of insulin, and other hormone secretion and inhibition of cell proliferation. Epidemiological studies have correlated low vitamin D levels to increased prevalence of some forms of cancer (mainly colon cancer but also breast and prostate cancer), type II diabetes, some autoimmune disorders, and cardiovascular diseases. However, in all these conditions, with a few exceptions, trials using high doses of vitamin D have been unsuccessful. The possibility that in nonskeletal diseases, different criteria for determining a vitamin D deficiency should be used is discussed.

Keywords

Vitamin D Bone metabolism Osteoporosis colon cancer Breast cancer Prostate cancer Diabetes Autoimmune diseases Cardiovascular diseases 

List of Abbreviations

Activated vitamin D

1,25(OH)2-vitamin D

PTH

Parathyroid hormone

VDR

Vitamin D receptor

CaM

Calmodulin

BBMI

Brush border myosin I

CaBP

Calbindin

TRPV6

Calcium channel 6

CaSR

Calcium sensing receptor

RIA

Radioimmunoassay

DEXA

Dual-energy X-ray absorptiometry

DC

Dendritic cells

Th cells

T helper cells

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Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  1. 1.Department of Health Sciences and Mother and Child CareUniversity of PalermoPalermoItaly

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