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Biomarkers in Bone Disease pp 393–405Cite as

Vitamin D: Biological Significance and Diagnosis of Mild Deficiency

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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.

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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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Authors and Affiliations

  1. Department of Health Sciences and Mother and Child Care, University of Palermo, Via delle Croci 47, 90139, Palermo, Italy

    Enrico Carmina

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  1. Enrico Carmina
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Correspondence to Enrico Carmina .

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Editors and Affiliations

  1. Department of Biomedical Sciences, Faculty of Science and Technology, University of Westminster, London, United Kingdom

    Vinood B. Patel

  2. Department of Nutrition and Dietetics, Division of Diabetes and Nutritional Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom

    Victor R. Preedy

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Carmina, E. (2017). Vitamin D: Biological Significance and Diagnosis of Mild Deficiency. In: Patel, V., Preedy, V. (eds) Biomarkers in Bone Disease. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7693-7_49

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