Nutrients 2013, 5(12), 5127-5139; doi:10.3390/nu5125127
Commentary

Does Vitamin D Sufficiency Equate to a Single Serum 25-Hydroxyvitamin D Level or Are Different Levels Required for Non-Skeletal Diseases?

1 Division of Health Sciences, University of South Australia, Adelaide, SA 5000, Australia 2 Discipline of General Practice, School of Population Health, University of Adelaide, Adelaide, SA 5005, Australia 3 SA Pathology, PO Box 14, Rundle Mall, Adelaide, SA 5000, Australia 4 School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
* Author to whom correspondence should be addressed.
Received: 28 October 2013; in revised form: 27 November 2013 / Accepted: 28 November 2013 / Published: 16 December 2013
(This article belongs to the Special Issue Vitamin D and Human Health)
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Abstract: Objective: Clarify the concept of vitamin D sufficiency, the relationship between efficacy and vitamin D status and the role of Vitamin D supplementation in the management of non-skeletal diseases. We outline reasons for anticipating different serum vitamin D levels are required for different diseases. Method: Review the literature for evidence of efficacy of supplementation and minimum effective 25-hydroxyvitamin D (25-OHD) levels in non-skeletal disease. Results: Evidence of efficacy of vitamin supplementation is graded according to levels of evidence. Minimum effective serum 25-OHD levels are lower for skeletal disease, e.g., rickets (25 nmol/L), osteoporosis and fractures (50 nmol/L), than for premature mortality (75 nmol/L) or non-skeletal diseases, e.g., depression (75 nmol/L), diabetes and cardiovascular disease (80 nmol/L), falls and respiratory infections (95 nmol/L) and cancer (100 nmol/L). Conclusions: Evidence for the efficacy of vitamin D supplementation at serum 25-OHD levels ranging from 25 to 100 nmol/L has been obtained from trials with vitamin D interventions that change vitamin D status by increasing serum 25-OHD to a level consistent with sufficiency for that disease. This evidence supports the hypothesis that just as vitamin D metabolism is tissue dependent, so the serum levels of 25-OHD signifying deficiency or sufficiency are disease dependent.
Keywords: vitamin D; dose response; thresholds; prevention; chronic disease

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MDPI and ACS Style

Spedding, S.; Vanlint, S.; Morris, H.; Scragg, R. Does Vitamin D Sufficiency Equate to a Single Serum 25-Hydroxyvitamin D Level or Are Different Levels Required for Non-Skeletal Diseases? Nutrients 2013, 5, 5127-5139.

AMA Style

Spedding S, Vanlint S, Morris H, Scragg R. Does Vitamin D Sufficiency Equate to a Single Serum 25-Hydroxyvitamin D Level or Are Different Levels Required for Non-Skeletal Diseases? Nutrients. 2013; 5(12):5127-5139.

Chicago/Turabian Style

Spedding, Simon; Vanlint, Simon; Morris, Howard; Scragg, Robert. 2013. "Does Vitamin D Sufficiency Equate to a Single Serum 25-Hydroxyvitamin D Level or Are Different Levels Required for Non-Skeletal Diseases?" Nutrients 5, no. 12: 5127-5139.

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