Vitamin D: Newer Concepts of Its Metabolism and Function at the Basic and Clinical Level

Abstract The interest in vitamin D continues unabated with thousands of publications contributing to a vast and growing literature each year. It is widely recognized that the vitamin D receptor (VDR) and the enzymes that metabolize vitamin D are found in many cells, not just those involved with calc...

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Bibliographic Details
Published in:Journal of the Endocrine Society 2020-02, Vol.4 (2), p.bvz038
Main Author: Bikle, Daniel D
Format: Article
Language:English
Subjects:
Alfacalcidol
Calcifediol
Enzymes
Mini-Reviews
Phosphates
Physiological aspects
Protein binding
Type 2 diabetes
Vitamin D
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Summary:Abstract The interest in vitamin D continues unabated with thousands of publications contributing to a vast and growing literature each year. It is widely recognized that the vitamin D receptor (VDR) and the enzymes that metabolize vitamin D are found in many cells, not just those involved with calcium and phosphate homeostasis. In this mini review I have focused primarily on recent studies that provide new insights into vitamin D metabolism, mechanisms of action, and clinical applications. In particular, I examine how mutations in vitamin D metabolizing enzymes—and new information on their regulation—links vitamin D metabolism into areas such as metabolism and diseases outside that of the musculoskeletal system. New information regarding the mechanisms governing the function of the VDR elucidates how this molecule can be so multifunctional in a cell-specific fashion. Clinically, the difficulty in determining vitamin D sufficiency for all groups is addressed, including a discussion of whether the standard measure of vitamin D sufficiency, total 25OHD (25 hydroxyvitamin) levels, may not be the best measure—at least by itself. Finally, several recent large clinical trials exploring the role of vitamin D supplementation in nonskeletal diseases are briefly reviewed, with an eye toward what questions they answered and what new questions they raised.
ISSN:2472-1972
2472-1972
DOI:10.1210/jendso/bvz038