Abstract
Sun exposure is the main source of vitamin D. Due to many lifestyle risk factors vitamin D deficiency/insufficiency is becoming a worldwide health problem. Low 25(OH)D concentration is associated with adverse musculoskeletal and non-musculoskeletal health outcomes. Vitamin D supplementation is currently the best approach to treat deficiency and to maintain adequacy. In response to a given dose of vitamin D, the effect on 25(OH)D concentration differs between individuals, and it is imperative that factors affecting this response be identified. For this review, a comprehensive literature search was conducted to identify those factors and to explore their significance in relation to circulating 25(OH)D response to vitamin D supplementation. The effect of several demographic/biological factors such as baseline 25(OH)D, aging, body mass index(BMI)/body fat percentage, ethnicity, calcium intake, genetics, oestrogen use, dietary fat content and composition, and some diseases and medications has been addressed. Furthermore, strategies employed by researchers or health care providers (type, dose and duration of vitamin D supplementation) and environment (season) are other contributing factors. With the exception of baseline 25(OH)D, BMI/body fat percentage, dose and type of vitamin D, the relative importance of other factors and the mechanisms by which these factors may affect the response remains to be determined.
Highlights
According to the Endocrine Society’s definition of vitamin D insufficiency and deficiency, 25(OH)D levels of 50–75 and below 50 nmol/L, respectively [1], it has been estimated that vitamin D insufficiency affects one billion people around the world [2]
There is a consensus between Ministry of Health and Cancer Society of New Zealand [7], Institute of Medicine [8] and American Academy of Dermatology (AAD) and AAD association [9] that the minimum 25(OH)D concentrations for a better health outcome are at least 50 nmol/L
We aimed to investigate possible factors and to examine their significance in relation to circulating 25(OH)D response to vitamin D supplementation
Summary
According to the Endocrine Society’s definition of vitamin D insufficiency and deficiency, 25(OH)D levels of 50–75 and below 50 nmol/L, respectively [1], it has been estimated that vitamin D insufficiency affects one billion people around the world [2]. It should be noted that depending on the definitions used by different scientific societies, the prevalence of vitamin D deficiency and insufficiency varies drastically. In response to a given dose of vitamin D supplement, the increase in 25(OH)D concentration has been reported to differ between individuals [10,11,12,13,14]. 25(OH)D concentrations (1.9%), leaving approximately 50% of the variations to unknown factors For these reasons, we aimed to investigate possible factors and to examine their significance in relation to circulating 25(OH)D response to vitamin D supplementation. Intervention trials that reported information on circulating 25(OH)D concentration at baseline and follow-up and reported data on factors predicting/affecting 25(OH)D response to vitamin D supplementation were considered. We first present an overview of vitamin D metabolism, biomarkers and roles in the body and present the results of the review
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