Vitamin D and its implications for musculoskeletal health in women: An update.

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Maturitas. 2007 Jun 28

Vitamin D and its implications for musculoskeletal health in women:

An update.

Pérez-López FR.Department of Obstetrics and Gynaecology, University

of Zaragoza, Faculty of Medicine, Domingo Miral s/n, Zaragoza 50009,

Spain.

Vitamin D is a hormone that controls phosphorus, calcium, and bone

metabolism and neuromuscular function. Vitamin D synthesis is a

process in which the skin, liver, and kidney are sequentially

involved. The vitamin D pool is completed by the amount taken with

food and supplements. Vitamin D deficiency causes osteopenia,

precipitates and exacerbates osteoporosis, causes a painful disease,

osteomalacia, and increases muscle weakness, which worsens the risk

of falls and fractures.

A high prevalence of vitamin D insufficiency exists in the

apparently healthy population, osteoporotic patients, and patients

with prior fractures.

Factors contributing to low vitamin D levels include low sunlight

exposure, decreased skin synthesis and intestinal absorption, and

inadequate diet. The simplest way to correct hypovitaminosis is

adequate nutrition and supplements. However, few patients with

osteoporosis and/or fractures, receive adequate supplements.

Vitamin D insufficiency may alter the regulatory mechanisms of

parathyroid hormone and may induce a secondary hyperparathyroidism

that increases the risk of osteoporosis and fractures, although the

necessary degree of this is not established. Monitoring of serum 25-

hydroxyvitamin D levels is the only way to assess vitamin D status.

The ideal healthy blood levels of 25-hydroxyvitamin D are

controversial, although a range from 30 to 60ng/mL is widely

accepted. The role of vitamin D supplementation is to provide humans

with the nutrient in an amount closer to the biological norm for our

species. This amount of vitamin D results in optimal function of

many aspects of health, including balance and muscle strength, thus

reducing the risk of fracture beyond what is possible via the

quality and quantity of bone itself.