Vitamin D Deficiency and Treatment in Children and Adults

Abstract

Vitamin D deficiency (hypovitaminosis D) has a very high prevalence worldwide. Over the last decade, there has been a growing interest in the research of vitamin D deficiency, its’ metabolites and repletion regimen. Vitamin D plays an important role in maintaining human physiologic process such as calcium and phosphate homeostasis, adaptive and innate immunity. Vitamin D deficiency can cause metabolic bone diseases such as rickets in children and osteomalacia in adults, and may have a major impact on extra-skeletal conditions such as diabetes, cancer, mortality, autoimmune and inflammatory disorders. Specific attention must be paid to high-risk groups such as the elderly, especially those living in institutional homes, people with limited sun exposure for various reasons such as religion, and people with darker skin. There are increasing numbers of children living with medical conditions in which either the condition or the treatment predisposes them to poor bone health and threatens their ability to attain peak bone mass. An understanding of calcium homeostasis and normal bone growth and development is essential for the paediatric endocrine nurse to be able to provide advice on lifestyle, supplement, and treatment options to this heterogeneous patient group. In adults, endocrine nurses need to understand the effects and recognise the importance of vitamin D deficiency on various organs and ensure appropriate assessment and management of vitamin D deficiency and assist in educating patients in how to improve their quality of life.