Vitamin D Deficiency – A Multifaceted Impact on Bone Health and Chronic Disease Risk
DOI:
https://doi.org/10.12775/QS.2025.40.59501Keywords
vitamin D, bone density, autoimmune diseases, cardiovascular disease, skin neoplasmsAbstract
Vitamin D is a crucial micronutrient traditionally linked to skeletal health through calcium and phosphate metabolism. However, emerging research highlights its broader physiological significance, including roles in muscle function, immune regulation, and chronic disease prevention. Despite endogenous synthesis via UVB exposure, deficiency remains a global concern due to limited sun exposure, dietary insufficiency, and certain health conditions. This review explores vitamin D metabolism, physiological functions, and clinical implications of deficiency. Evidence shows its deficiency contributes to skeletal disorders such as rickets, osteomalacia, and osteoporosis. Additionally, low vitamin D levels are associated with increased risks of autoimmune diseases (e.g., multiple sclerosis, rheumatoid arthritis, type 1 diabetes), cardiovascular diseases, metabolic disorders (e.g., type 2 diabetes), and colorectal cancer. Calcitriol, the active form of vitamin D, exhibits neuroprotective properties, suggesting potential benefits in neurodegenerative diseases like Alzheimer’s and Parkinson’s. Supplementation studies indicate improvements in bone density, muscle strength, and immune function, particularly in at-risk populations. Beyond bone health, vitamin D is integral to overall physiological function. Addressing deficiency through responsible sun exposure and tailored supplementation may mitigate chronic disease risk. Further research is essential to refine supplementation guidelines, elucidate molecular mechanisms, and integrate findings into public health strategies.
References
1. Holick MF. "Vitamin D deficiency: a worldwide problem with health consequences." Am J Clin Nutr. 2008 Apr;87(4):1080S-1086S. PMID: 18400738.
2. Lips P. "Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications." Endocr Rev. 2001 Aug;22(4):477-501. PMID: 11493580.
3. Bischoff-Ferrari HA, et al. "Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials." JAMA. 2005 May 11;293(18):2257-64. PMID: 15886381.
4. Chapuy MC, et al. "Vitamin D3 and calcium to prevent hip fractures in elderly women." N Engl J Med. 1992 Dec 3;327(23):1637-42. PMID: 1331788.
5. Dawson-Hughes B, et al. "Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older." N Engl J Med. 1997 Sep 4;337(10):670-6. PMID: 9278463.
6. "Guidelines for Preventing and Treating Vitamin D Deficiency: A 2023 Update in Poland." Nutrients. 2023 Jan 30;15(3):695. doi: 10.3390/nu15030695.
7. Lips P, van Schoor NM. "The effect of vitamin D on bone and osteoporosis." Best Pract Res Clin Endocrinol Metab. 2011 Aug;25(4):585-91. PMID: 21872800.
8. Wacker M, Holick MF. "Vitamin Du2013effects on skeletal and extraskeletal health and the need for supplementation." Nutrients. 2013 Jan;5(1):111-48. doi:10.3390/nu5010111.
9. Vieth R. "Vitamin D toxicity, policy, and science." J Bone Miner Res. 2007 Dec;22 Suppl 2:V64-8. PMID: 18290725.
10. Holick MF. "High prevalence of vitamin D inadequacy and implications for health." Mayo Clin Proc. 2006 Mar;81(3):353-73. PMID: 16529140.
11. Carlberg C, Haq A. "The concept of the personal vitamin D response index." J Steroid Biochem Mol Biol. 2018 Jan;175:12-17. doi:10.1016/j.jsbmb.2016.12.011.
12. Bikle DD. "Vitamin D metabolism, mechanism of action, and clinical applications." Chem Biol. 2014;21(3):319-29. doi:10.1016/j.chembiol.2013.12.016.
13. Bischoff-Ferrari HA, et al. "Vitamin D supplementation and fracture prevention: a meta-analysis of randomized controlled trials." Arch Intern Med. 2009 Mar 23;169(6):551-61. PMID: 19307517.
14. Sanders KM, et al. "Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial." JAMA. 2010 May 12;303(18):1815-22. PMID: 20460620.
15. Holick MF. "Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis." Am J Clin Nutr. 2004 Mar;79(3):362-71. PMID: 14985208.
16. Jackson RD, et al. "Calcium plus vitamin D supplementation and the risk of fractures." N Engl J Med. 2006 Feb 16;354(7):669-83. PMID: 16481635.
17. Avenell A, et al. "Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men." Cochrane Database Syst Rev. 2014 Apr 14;(4):CD000227. PMID: 24729336.
18. Dawson-Hughes B, et al. "Estimates of optimal vitamin D status." Osteoporos Int. 2005 Jul;16(7):713-6. PMID: 15776217.
19. Bouillon R, Marcocci C, et al. "Skeletal and extraskeletal actions of vitamin D: current evidence and outstanding questions." Endocr Rev. 2019 Oct;40(5):1109-1151. doi:10.1210/er.2018-00126.
20. Holick MF, et al. "Vitamin D and sun exposure: skin cancer prevention or bone health compromise?" J Steroid Biochem Mol Biol. 2007 Mar;103(3-5):633-7. PMID: 17270249.
21. Kimlin MG. "Geographic location and vitamin D synthesis." Mol Aspects Med. 2008 Dec;29(6):453-61. doi:10.1016/j.mam.2008.08.005.
22. Webb AR. "Who, what, where and when-influences on cutaneous vitamin D synthesis." Prog Biophys Mol Biol. 2006 Sep;92(1):17-25. PMID: 16766240.
23. Garland CF, et al. "The role of vitamin D in cancer prevention." Am J Public Health. 2006 Feb;96(2):252-61. PMID: 16380576.
24. Autier P, et al. "Vitamin D status and ill health: a systematic review." Lancet Diabetes Endocrinol. 2014 Jan;2(1):76-89. doi:10.1016/S2213-8587(13)70165-7.
25. Pludowski P, et al. "Vitamin D supplementation guidelines." J Steroid Biochem Mol Biol. 2018 Apr;175:125-35. doi:10.1016/j.jsbmb.2017.01.021.
26. Lips P. "Worldwide status of vitamin D nutrition." J Steroid Biochem Mol Biol. 2010 Jul;121(1-2):297-300. PMID: 20197091.
27. Manson JE, et al. "Vitamin D and chronic disease prevention." N Engl J Med. 2020;382(6):553-556. doi:10.1056/NEJMc1915240.
28. DeLuca HF. "Overview of general physiological features and functions of vitamin D." Am J Clin Nutr. 2004 Dec;80(6):1689S-1696S. PMID: 15585789.
29. Bikle DD. "Vitamin D: newly discovered actions require reconsideration of physiologic requirements." Trends Endocrinol Metab. 2012 Jul;23(7):375-8. doi:10.1016/j.tem.2012.02.003.
30. Holick MF, et al. "Prevention and treatment of vitamin D deficiency." Nat Rev Endocrinol. 2012 Oct;8(10):597-609. doi:10.1038/nrendo.2012.108.
31. Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A. Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA. 2006 Dec 20;296(23):2832-8. PMID: 17179460
32. Ascherio A, Munger KL. Epidemiology of multiple sclerosis: from risk factors to prevention – an update. Semin Neurol. 2016 Feb;36(02):103-114. PMID: 27068559
33. Hu W, Li S, Yang J, et al. Serum 25-hydroxyvitamin D levels and the risk of multiple sclerosis: a meta-analysis. Int J Neurosci. 2019 Jul;129(7):573-582. PMID: 30376920
34. Pierrot-Deseilligny C, Souberbielle JC. Contribution of vitamin D insufficiency to the pathogenesis of multiple sclerosis. Ther Adv Neurol Disord. 2017 Nov;10(6):491-501. PMID: 29152516
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Copyright (c) 2025 Adam Sobiński, Aleksandra Sadowska, Aleksandra Welkier, Joanna Miśkiewicz, Aleksandra Dudek, Patrycja Pietrusińska, Jakub Moder, Anna Dziewierz, Paula Kwaśniewska, Patrycja Śliwa-Tytko

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