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A Scoping Review of Vitamin D for Nonskeletal Health: A Framework for Evidence-based Clinical Practice.
Santos, Heitor O; Martins, Carlos Eduardo C; Forbes, Scott C; Delpino, Felipe M.
  • Santos HO; School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil. Electronic address: heitoroliveirasantos@gmail.com.
  • Martins CEC; School of Medicine, University of São Paulo, São Paulo, Brazil.
  • Forbes SC; Department of Physical Education Studies, Brandon University, Brandon, Manitoba, Canada.
  • Delpino FM; Postgraduate in Nursing, Federal University of Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil.
Clin Ther ; 45(5): e127-e150, 2023 05.
Article in English | MEDLINE | ID: covidwho-2303095
ABSTRACT

BACKGROUND:

Low serum 25-hydroxy-vitamin D [25(OH)D] levels are prevalent worldwide. Although the benefits of vitamin D supplementation have focused on skeletal disorders (eg, rickets, osteomalacia, osteoporosis), emerging evidence for nonskeletal health merits further discussion.

PURPOSE:

The purpose of this review was to critically examine the vitamin D supplementation literature pertaining to nonskeletal health to help guide clinicians.

METHODS:

A scoping review that included observational studies and randomized clinical trials (RCTs) was performed. Evidence from meta-analyses and individual RCTs are discussed, and controversies and future directions are considered.

FINDINGS:

25(OH)D deficiency is a ubiquitous condition associated with multiple nonskeletal diseases, including cardiometabolic (heart disease, diabetes, and kidney disease), immune (HIV/AIDS and cancer), lung (from traditional chronic disorders to coronavirus disease 2019), and gut diseases. Vitamin D deficiency also affects health across the life span (children, pregnant, and elderly), mental illness, and reproduction in both men and women. In contrast, vitamin D supplementation does not necessarily improve major medical outcomes, even when low 25(OH)D levels are treated. Screening for 25(OH)D status remains an important practice, primarily for high-risk patients (eg, elderly, women with osteoporosis, people with low exposure to sunlight). It is reasonable to supplement with vitamin D to treat 25(OH)D deficiency, such that if beneficial nonskeletal health occurs, this may be considered as a coadjutant instead of the central tenet of the disease. Furthermore, optimizing dosing regimens is an important clinical consideration. IMPLICATIONS Although 25(OH)D deficiency is prevalent in nonskeletal diseases, there is no uniform evidence that vitamin D supplementation improves major medical outcomes, even when low 25(OH)D levels are corrected. Findings from RCTs warrant caution due to possible selection bias. Overall, vitamin D supplementation must be guided by circulating levels as a reasonable medical practice to correct 25(OH)D deficiency.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Osteoporosis / Vitamin D Deficiency / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials / Reviews Topics: Long Covid / Traditional medicine Limits: Aged / Child / Female / Humans / Male / Pregnancy Language: English Journal: Clin Ther Year: 2023 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Osteoporosis / Vitamin D Deficiency / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials / Reviews Topics: Long Covid / Traditional medicine Limits: Aged / Child / Female / Humans / Male / Pregnancy Language: English Journal: Clin Ther Year: 2023 Document Type: Article