THE GLOBAL EPIDEMIOLOGY OF VITAMIN D STATUS
M.H. Edwards, Z.A. Cole, N.C. Harvey, C. Cooper
J Aging Res Clin Practice 2014;3(3):148-158
Objective: Vitamin D is an important component of calcium and phosphate metabolism, ensuring, with PTH and FGF23, adequate serum concentrations of these two analytes for optimal cell function and bone mineralisation. Despite a surge of interest in vitamin D physiology over the last decade, a single threshold for deficiency remains uncertain in functional terms, and it is clear that correlation between serum concentration of 25(OH)-vitamin D and disease outcomes is very poor at the level of the individual. In this review, we describe the physiology of vitamin D, its potential associations with disease, and relate, in detail, the epidemiology of vitamin D status across populations worldwide. Design: Through a comprehensive literature review, we identified relevant studies from Europe, the Middle East, Africa, Asia, North America, Latin America, and Oceania. Results: Although rickets and osteomalacia are established potential consequences of vitamin D deficiency, evidence for low levels of vitamin D as a cause of the multitude of other health outcomes with which they have been linked is lacking. We observed geographical differences in serum 25(OH)-vitamin D concentrations, which may be partly, but not wholly, explained by factors such as sunlight exposure, skin pigmentation, skin coverage, dietary choices, supplements, adiposity, malabsorption, disease, demographics and lifestyle. Conclusion: We conclude that low serum concentrations of 25(OH)-vitamin D appear common across the globe; the relevance of this observation to human health remains to be elucidated.
M.H. Edwards ; Z.A. Cole ; N.C. Harvey ; C. Cooper (2014): THE GLOBAL EPIDEMIOLOGY OF VITAMIN D STATUS . The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2014.26