Author(s):
Chevalley, Thierry ; Brandi, Maria Luisa ; Cashman, Kevin D. ; Cavalier, Etienne ; Harvey, Nicholas C. ; Maggi, Stefania ; Cooper, Cyrus ; Al-Daghri, Nasser ; Bock, Oliver ; Bruyère, Olivier ; Rosa, Mário Miguel ; Cortet, Bernard ; Cruz-Jentoft, Alfonso J. ; Cherubini, Antonio ; Dawson-Hughes, Bess ; Fielding, Roger ; Fuggle, Nicholas ; Halbout, Philippe ; Kanis, John A. ; Kaufman, Jean-Marc ; Lamy, Olivier ; Laslop, Andrea ; Yerro, Maria Concepción Prieto ; Radermecker, Régis ; Thiyagarajan, Jotheeswaran Amuthavalli ; Thomas, Thierry ; Veronese, Nicola ; de Wit, Marten ; Reginster, Jean-Yves ; Rizzoli, René
Date: 2022
Persistent ID: http://hdl.handle.net/10451/57228
Origin: Repositório da Universidade de Lisboa
Subject(s): Falls; Fragility fracture; Osteoarthritis; Vitamin D
Description
Vitamin D is a key component for optimal growth and for calcium-phosphate homeostasis. Skin photosynthesis is the main source of vitamin D. Limited sun exposure and insufficient dietary vitamin D supply justify vitamin D supplementation in certain age groups. In older adults, recommended doses for vitamin D supplementation vary between 200 and 2000 IU/day, to achieve a goal of circulating 25-hydroxyvitamin D (calcifediol) of at least 50 nmol/L. The target level depends on the population being supplemented, the assessed system, and the outcome. Several recent large randomized trials with oral vitamin D regimens varying between 2000 and 100,000 IU/month and mostly conducted in vitamin D-replete and healthy individuals have failed to detect any efficacy of these approaches for the prevention of fracture and falls. Considering the well-recognized major musculoskeletal disorders associated with severe vitamin D deficiency and taking into account a possible biphasic effects of vitamin D on fracture and fall risks, an European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) working group convened, carefully reviewed, and analyzed the meta-analyses of randomized controlled trials on the effects of vitamin D on fracture risk, falls or osteoarthritis, and came to the conclusion that 1000 IU daily should be recommended in patients at increased risk of vitamin D deficiency. The group also addressed the identification of patients possibly benefitting from a vitamin D loading dose to achieve early 25-hydroxyvitamin D therapeutic level or from calcifediol administration.
