A Scoping Review of Vitamin D for Nonskeletal Health: A Framework for Evidence-based Clinical Practice |
| |
| Institution: | 1. School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil;2. School of Medicine, University of São Paulo, São Paulo, Brazil;3. Department of Physical Education Studies, Brandon University, Brandon, Manitoba, Canada;4. Postgraduate in Nursing, Federal University of Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil;1. Department of Cardiac Surgery, Hainan Provincial People''s Hospital (Hainan Hospital affiliated with Hainan Medical College), Haikou, China;2. Department of General Medicine, Harbin Sixth Hospital, Harbin, China;3. Qiongtai Normal University, Haikou, China;4. Department of Pharmacy, Hainan Provincial People''s Hospital (Hainan Hospital affiliated with Hainan Medical College), Haikou, China;5. Department of Cardiology, Tangdu Hospital, Second Affiliated Hospital of Air Force Military Medical University, Xi''an, China;6. Department of cardiology, The First Affiliated hospital of Wannan Medical College. Wuhu, Anhui, 241001, china;1. Division of Pediatric Infectious Diseases, Ann & Robert H. Lurie Children''s Hospital of Chicago Northwestern University Feinberg School of Medicine, Chicago, IL;2. Department of Pediatrics, Warren Alpert Medical School of Brown University, Women & Infants Hospital of Rhode Island, Providence, RI;1. Certara Strategic Consulting Services, Princeton, New Jersey, USA;2. Merck & Co, Inc, Rahway, New Jersey, USA;1. Daré Bioscience, Inc, San Diego, California, USA;2. University of Pittsburgh and Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA;3. Gendreau Consulting, LLC, Poway, California, USA;4. Health Decisions, Inc, Durham, North Carolina, USA;5. Segal Trials, University of Miami Miller School of Medicine, Miami, Florida, USA;6. Precision Trials AZ, LLC, Phoenix, Arizona, USA;7. Praetorian Pharmaceutical Research and West Jefferson Medical Center, Marrero, Louisiana, USA;8. Institutional-Southern Clinical Research Associates, LLC, Metairie, Louisiana, USA;9. TMC Life Research, Inc, Houston, TX;10. Formerly of Daré Bioscience, Inc, San Diego, California, USA |
| |
| Abstract: | BackgroundLow 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.PurposeThe purpose of this review was to critically examine the vitamin D supplementation literature pertaining to nonskeletal health to help guide clinicians.MethodsA 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.Findings25(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.ImplicationsAlthough 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. |
| |
| Keywords: | 25(OH)D |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
