What Value is there in Assessing Postmenopausal Women for Vitamin D Deficiency? - Revista Brasileira de Ginecologia e Obstetrícia
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(11):585-586
Vitamin D is included, along with thyroid and steroid hormones, within the unique category of endocrine molecules that act through nuclear receptors. Differently from its partners, until recently vitamin D was thought to be a specialized hormone with an action limited to the control of mineral and bone metabolism. The misconception has been recently reviewed after the recognition that the vitamin D receptor (VDR) as well as the cell machinery to synthesize the active hormone 1,25(OH)2D are largely distributed among most tissues and cells. Therefore, vitamin D can potentially modulate an ample diversity of systems and functions, including the cardiovascular system, energy metabolism, immune modulation and cell proliferation. The new knowledge reinvigorated the interest to unveil the ideal levels of vitamin D to obtain osteomineral, as well as non-mineral health.
The biochemical measurement of 25-hydroxivitamin D (25-OHD) is considered the best surrogate parameter to assess the status of vitamin D sufficiency. Until 2010, the cut-off point for 25-OHD serum levels was set at 15 ng/mL, and it was an uncommon laboratory parameter, seldom requested by a specialist. Since then, a passionate discussion emerged regarding one key point: what are the ideal serum levels of 25-OHD? Some authors have stated that they are the serum levels that are able to promote the intestinal absorption of calcium, stabilize parathyroid (PTH) serum levels and enable porper bone mineralization. However, this point is still a conundrum.
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Vitamin D is included, along with thyroid and steroid hormones, within the unique category of endocrine molecules that act through nuclear receptors. Differently from its partners, until recently vitamin D was thought to be a specialized hormone with an action limited to the control of mineral and bone metabolism. The misconception has been recently reviewed after the recognition that the vitamin D receptor (VDR) as well as the cell machinery to synthesize the active hormone 1,25(OH)2D are largely distributed among most tissues and cells. Therefore, vitamin D can potentially modulate an ample diversity of systems and functions, including the cardiovascular system, energy metabolism, immune modulation and cell proliferation. The new knowledge reinvigorated the interest to unveil the ideal levels of vitamin D to obtain osteomineral, as well as non-mineral health.
The biochemical measurement of 25-hydroxivitamin D (25-OHD) is considered the best surrogate parameter to assess the status of vitamin D sufficiency. Until 2010, the cut-off point for 25-OHD serum levels was set at 15 ng/mL, and it was an uncommon laboratory parameter, seldom requested by a specialist. Since then, a passionate discussion emerged regarding one key point: what are the ideal serum levels of 25-OHD? Some authors have stated that they are the serum levels that are able to promote the intestinal absorption of calcium, stabilize parathyroid (PTH) serum levels and enable porper bone mineralization. However, this point is still a conundrum.
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