Vitamin D pp 287-305 | Cite as

Vitamin D and Bone Health in Adults and the Elderly

  • Clifford J. Rosen
Part of the Nutrition and Health book series (NH)


Vitamin D is one of the principle hormonal regulators of calcium homeostasis in the body. Besides being critically important for calcium and phosphate absorption in the intestine, vitamin D is essential for normal mineralization of bone and has major regulatory effects on bone cells in the bone remodeling unit. In addition to distant skeletal and intestinal effects, the active form of vitamin D, 1,25-dihydroxyvitamin D3 [1,25(OH)2D3], also regulates its own synthesis in the kidney and parathyroid hormone (PTH) secretion in the parathyroid gland. These multisystem effects firmly establish the importance of this hormone in the maintenance of skeletal health. Moreover, perturbations in vitamin D synthesis, secretion, or action have been implicated as potential pathogenetic factors in the development of osteoporosis. For these reasons, there has been sustained interest in vitamin D and 1,25(OH)2D3 as therapeutic agents in several metabolic bone disorders. However, the relationship between active vitamin D and its metabolites and calcified tissue components is complex and redundant. Hence a thorough understanding of the role vitamin D plays in the bone remodeling process (either directly or indirectly) is extremely important. In turn, complete delineation of the physiologic role of vitamin D in mineral homeostasis illustrates why vitamin D deficiency, especially in the elderly, is now being recognized as a major public health issue.


Vertebral Fracture Postmenopausal Osteoporosis Renal Osteodystrophy Adult Celiac Disease Remodel Unit 
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  • Clifford J. Rosen

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