Problème santé lié au trouble de vitamine D chez le senior

[Nutrimuscle-Diététique]

Traduction de l'étude

Le rôle de la vitamine D dans la neuroprotection dans la sclérose en plaques : une mise à jour
par Amarpreet Sangha Nutrients 2023, 15(13), 2978 ;

La sclérose en plaques (SEP) est une affection neurologique complexe qui implique à la fois des composants inflammatoires démyélinisants et neurodégénératifs. La recherche et les traitements de la SEP se sont traditionnellement concentrés sur l'immunomodulation, avec moins d'investigations sur la neuroprotection, et cela est vrai pour le rôle de la vitamine D dans la SEP. Les chercheurs ont déjà établi que la vitamine D joue un rôle anti-inflammatoire dans la modulation du système immunitaire dans la SEP. Plus récemment, des chercheurs ont commencé à étudier le rôle neuroprotecteur potentiel de la vitamine D dans la SEP.

La forme active de la vitamine D, 1,25(OH)2D3, possède une gamme de propriétés neuroprotectrices, qui peuvent être importantes dans la remyélinisation et/ou la prévention de la démyélinisation. La découverte la plus notable concernant la SEP est que la 1,25(OH)2D3 favorise la prolifération des cellules souches et entraîne la différenciation des cellules souches neurales en oligodendrocytes, qui effectuent la remyélinisation. De plus, la 1,25(OH)2D3 neutralise la neurodégénérescence et le stress oxydatif en supprimant l'activation des astrocytes réactifs et de la microglie M1. La 1,25(OH)2D3 favorise également l'expression de divers facteurs neuroprotecteurs, dont les neurotrophines et les enzymes antioxydantes. La 1,25(OH)2D3 diminue la perméabilité de la barrière hémato-encéphalique, réduisant ainsi le recrutement des leucocytes dans le système nerveux central. Ces effets neuroprotecteurs, stimulés par la 1,25(OH)2D3, améliorent tous la survie neuronale. Cette revue résume et relie les preuves actuelles à l'appui des mécanismes d'action médiés par la vitamine D pour la neuroprotection dans la SEP.

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Supplementation of vitamin D isolated or calcium-associated on bone remodeling and fracture risk in postmenopausal women without osteoporosis: A systematic review of randomized clinical trials
Nutrition 6 July 2023, Aline Rocha Reis

Highlights
• Vitamin D supplementation, alone or with Ca, reduce the PTH levels
• Vitamin D supplementation, alone or with Ca, reduced alkaline phosphatase levels
• Vitamin D supplementation, alone or with Ca, wasn't pragmatic in improving the BMD
• Vitamin D supplementation is inconclusive in reducing the risk of bone fractures
• Vitamin D supplementation, alone or associated with Ca, improved the 25(OH)D levels

Menopause and vitamin D deficiency increase bone reabsorption and bone fracture risk in women in postmenopause, and vitamin D supplementation may improve bone health and decrease bone fracture risk. This study aims to discuss the effect of vitamin D supplementation, isolated or calcium-associated, on remodeling and fracture risk bone in women in postmenopause without osteoporosis. This study was conducted according to PRISMA guidelines (PROSPERO database registration: CRD42022359796). Search was conducted in four databases and gray literature using MeSH and similar terms related to supplements, vitamin D, calcium, remodeling and fracture bone, without the restriction of language and year of publication. A total of 3,460 studies were identified, and nine were selected. Vitamin D supplementation increased 25(OH)D levels by at least 10 ng/mL, and decreases PTH secretion dependent of baseline levels. The doses of 400 IU of vitamin D improved %carbOC, while 800-1,000 IU combined with calcium resulted in reduced, improved or maintained BMD and reduced alkaline phosphatase levels. However, 4,000 IU alone or combined with calcium for six months did not improve CTX and P1NP levels.

Additionally, 15,000 IU/week increased the cortical area of metacarpal bone; while 500,000 IU/vitamin D annual for five years did not contribute to reducing the fracture risk and falls. Only a study showed a reduction in fracture risk (dose of 800 UI/vitamin D plus 1,200 mg/calcium).

Thus, the vitamin D supplementation, alone or calcium-combined, improve status of 25(OH)D and bone remodeling, but was not possible to assert that reduced fracture bone risk in postmenopausal women.

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The Mutual Interplay between Bone, Glucose and Lipid Metabolism: The Role of Vitamin D and PTH
by Vittoria Carmela Danese Nutrients 2023, 15(13), 2998;

Background. We sought to investigate the mutual interplay between bone, glucose and lipid metabolism in a wide cohort of community-based subjects. Methods. We studied 1240 blood donors (F/M ratio 1/3.2, mean age 41.9 ± 11.7 SD). Serum ionized (Ca++), magnesium (Mg++), 25-hydroxy-vitamin D [25(OH)D], PTH-1-84, 1,25-dihydroxyvitamin D [1,25(OH)2D], total cholesterol (C), HDL-C, triglycerides and glucose were measured and LDL-C levels were calculated in all subjects. Results. 25(OH)D negatively correlated with BMI (R = −0.11), PTH (R = −0.16) (p < 0.0001), total C (R = −0.06, p < 0.05) and triglycerides (R = −0.13, p < 0.0001) and positively with 1,25(OH)2D (R = 0.12) and creatinine (R = 0.17) (p < 0.0001). Serum PTH positively correlated with total C (R = 0.08, p < 0.01), LDL-C (R = 0.1, p < 0.001), triglycerides (R = 0.09, p < 0.01) and glucose (R = 0.15, p < 0.0001) and negatively with HDL-C (R = −0.09, p < 0.01). The odds of showing abnormal serum triglycerides and HDL-C increased as 25(OH)D decreased (p < 0.0001 and p < 0.03) and PTH increased (p < 0.03 and p = 0.05), while the odds of showing abnormal LDL-C levels increased in association with elevated PTH (p < 0.01).

Conclusion. Vitamin D, PTH, glucose and lipid metabolism are mutually influenced. Hypovitaminosis D predisposes toward worsening lipid profiles through the actions of PTH, while serum PTH levels per se associate with higher glucose and LDL-C levels.

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Association between Vitamin D Deficiency and Clinical Parameters in Men and Women Aged 50 Years or Older: A Cross-Sectional Cohort Study
by Ji Hyun Lee
Nutrients 2023, 15(13), 3043;

Vitamin D deficiency (VDD) is increasingly prevalent on a global scale and is connected to chronic health issues including diabetes, obesity, and inflammation. This study aimed to investigate the association between VDD and various clinical parameters including glycated hemoglobin (HbA1c), body mass index (BMI), and inflammatory markers. This cross-sectional cohort study included Korean men and women aged 50 years and older (290 men, 125 women); VDD was classified as serum 25-hydroxyvitamin D (25[OH]D) levels below 20 ng/mL. Vitamin D deficiency was more prevalent in men (64.5%) compared to that in women (35.2%). Men with VDD had higher fat mass and HbA1c levels, lower muscle strength, and worse physical performance. Among women, VDD was associated with higher BMI, HbA1c, tumor necrosis factor-alpha (TNF-α), and creatinine levels. In women, 25(OH)D levels exhibited an inverse relationship with HbA1c, BMI, and TNF-α concentrations. However, there were no differences in the levels of interleukin-6 and interleukin-1 beta according to vitamin D status in both men and women. Vitamin D deficiency is linked to higher HbA1c, BMI, and inflammatory markers in older Korean women, thus warranting the maintenance of sufficient vitamin D levels for overall health.

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Traduction de l'étude

Association entre la carence en vitamine D et les paramètres cliniques chez les hommes et les femmes âgés de 50 ans ou plus : une étude de cohorte transversale
par Ji Hyun Lee
Nutriments 2023, 15(13), 3043 ;

La carence en vitamine D (VDD) est de plus en plus répandue à l'échelle mondiale et est liée à des problèmes de santé chroniques, notamment le diabète, l'obésité et l'inflammation. Cette étude visait à étudier l'association entre la VDD et divers paramètres cliniques, notamment l'hémoglobine glyquée (HbA1c), l'indice de masse corporelle (IMC) et les marqueurs inflammatoires. Cette étude de cohorte transversale a inclus des hommes et des femmes coréens âgés de 50 ans et plus (290 hommes, 125 femmes) ; Le VDD a été classé comme des taux sériques de 25-hydroxyvitamine D (25[OH]D) inférieurs à 20 ng/mL. La carence en vitamine D était plus fréquente chez les hommes (64,5 %) que chez les femmes (35,2 %). Les hommes atteints de VDD avaient une masse grasse et des taux d'HbA1c plus élevés, une force musculaire plus faible et de moins bonnes performances physiques. Chez les femmes, la VDD était associée à des taux d'IMC, d'HbA1c, de facteur de nécrose tumorale alpha (TNF-α) et de créatinine plus élevés. Chez les femmes, les niveaux de 25(OH)D présentaient une relation inverse avec les concentrations d'HbA1c, d'IMC et de TNF-α. Cependant, il n'y avait aucune différence dans les niveaux d'interleukine-6 et d'interleukine-1 bêta selon le statut en vitamine D chez les hommes et les femmes. La carence en vitamine D est liée à une HbA1c, un IMC et des marqueurs inflammatoires plus élevés chez les femmes coréennes plus âgées, ce qui justifie le maintien de niveaux suffisants de vitamine D pour la santé globale.

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Prevalence of vitamin D deficiency in seniors – a retrospective study
Stefan Haitchi Clin Nutr July 25, 2023

Background & Aims
Vitamin D deficiency is a condition with different causes. It is associated with numerous comorbidities such as autoimmune diseases, bone diseases, cancer, cardiovascular diseases, neurodegenerative diseases, psychiatric diseases, and respiratory infections like COVID-19. Due to its high prevalence all over the world, it is a major task for health care systems worldwide. Through a combination of low sunlight exposure, insufficient nutrition, and age-related changes in skin, liver, and kidney function, especially seniors and nursing home residents, in particular, have a significantly increased risk of developing a vitamin D deficiency.
Methods
This retrospective study analyzed the prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D [25(OH)D] < 12 ng/ml) amongst selected Austrian nursing home seniors. It also examined whether demographic data and other laboratory values like calcium correlate with vitamin D levels by using the Pearson correlation coefficient. This correlation was graphically illustrated with a scatter plot and regression line. A total of 478 patients admitted to a nursing home in Vienna between January 3, 2017, and August 31, 2020, were included.
Results
A total of 106 seniors (22,2%) suffered from a manifest vitamin D deficiency. The vitamin D level of the men was significantly lower than the level of the women (22.9 ± 12.6 ng/ml vs. 26.2 ± 14.8 ng/ml, p = 0.027). The vitamin D serum levels significantly correlated with the serum calcium levels of the participants (r = 0.19, p < 0.001). 39.5% (189 out of 478) of the nursing home residents had inadequate serum vitamin D levels.
Conclusions
In summary, it can be said that the prevalence of vitamin D deficiency among nursing home residents is considerably high. Inadequate vitamin D levels were often associated with reduced calcium levels. Given the high prevalence, the numerous negative health consequences of inadequate levels, and the large therapeutic index, this risk group should get a general supplementation with a dose of 25 μg (1000 IU) vitamin D3 per day. In addition, a blood examination should be performed as early as three months after the start of the supplementation therapy. If some residents do not achieve an adequate vitamin D concentration, the substitution has to be adapted to the individual needs to treat them as precisely as possible.

[Nutrimuscle-Diététique]

Traduction de l'étude

Prévalence de la carence en vitamine D chez les personnes âgées – une étude rétrospective
Stefan Haitchi Clin Nutr 25 juillet 2023

Contexte et objectifs
La carence en vitamine D est une maladie dont les causes sont différentes. Il est associé à de nombreuses comorbidités telles que les maladies auto-immunes, les maladies osseuses, le cancer, les maladies cardiovasculaires, les maladies neurodégénératives, les maladies psychiatriques et les infections respiratoires comme le COVID-19. En raison de sa forte prévalence dans le monde entier, il s'agit d'une tâche majeure pour les systèmes de santé du monde entier. En raison d'une combinaison d'une faible exposition au soleil, d'une nutrition insuffisante et de changements liés à l'âge de la peau, du foie et des fonctions rénales, les personnes âgées et les résidents des maisons de retraite, en particulier, ont un risque considérablement accru de développer une carence en vitamine D.
Méthodes
Cette étude rétrospective a analysé la prévalence de la carence en vitamine D (25-hydroxyvitamine D sérique [25(OH)D] < 12 ng/ml) chez des personnes âgées sélectionnées dans des maisons de retraite autrichiennes. Il a également examiné si les données démographiques et d'autres valeurs de laboratoire comme le calcium étaient en corrélation avec les niveaux de vitamine D en utilisant le coefficient de corrélation de Pearson. Cette corrélation a été illustrée graphiquement par un nuage de points et une ligne de régression. Un total de 478 patients admis dans une maison de repos à Vienne entre le 3 janvier 2017 et le 31 août 2020 ont été inclus.
Résultats
Au total, 106 personnes âgées (22,2 %) souffraient d'une carence manifeste en vitamine D. Le taux de vitamine D des hommes était significativement inférieur à celui des femmes (22,9 ± 12,6 ng/ml vs 26,2 ± 14,8 ng/ml, p = 0,027). Les taux sériques de vitamine D étaient significativement corrélés avec les taux sériques de calcium des participants (r = 0,19, p < 0,001). 39,5% (189 sur 478) des résidents des maisons de retraite avaient des taux sériques de vitamine D insuffisants.
conclusion
En résumé, on peut dire que la prévalence de la carence en vitamine D chez les résidents des maisons de retraite est considérablement élevée. Des niveaux inadéquats de vitamine D étaient souvent associés à des niveaux de calcium réduits. Compte tenu de la prévalence élevée, des nombreuses conséquences négatives sur la santé de niveaux inadéquats et de l'indice thérapeutique élevé, ce groupe à risque devrait recevoir une supplémentation générale avec une dose de 25 μg (1000 UI) de vitamine D3 par jour. De plus, un examen sanguin doit être effectué dès trois mois après le début de la thérapie de supplémentation. Si certains résidents n'atteignent pas une concentration adéquate en vitamine D, la substitution doit être adaptée aux besoins individuels pour les traiter aussi précisément que possible.

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Prescription of vitamin D was associated with a lower incidence of hip fractures
Mitsutaka Yakabe Scientific Reports volume 13, Article number: 12889 (2023)

Patients with osteoporosis are prone to fragility fractures. Evidence of the effects of active forms of vitamin D on hip fracture prevention is insufficient. We examined the association between vitamin D prescription and incidence of new fractures using the data of osteoporotic patients from the nationwide health insurance claims database of Japan. The follow-up period was 3 years after entry. The untreated patients were never prescribed vitamin D during follow-up (n = 422,454), and the treated patients had a vitamin D medication possession ratio of ≥ 0.5 at all time points (n = 169,774). Propensity score matching was implemented on these groups, yielding 105,041 pairs, and subsequently, the control and treatment groups were established and analyzed.

The incidence of new fractures was significantly lower in the treatment group compared with the control group (6.25% vs. 5.69%, hazard ratio 0.936 [95% confidence interval 0.904–0.970], p < 0.001*). By site, hip fractures significantly decreased (0.89% vs. 0.42%, p < 0.001), but not vertebral and radial fractures. Subgroup analysis by vitamin D type showed a significantly lower incidence of total fractures only in alfacalcidol (hazard ratio 0.676 [95% confidence interval 0.628–0.728], p < 0.001*).

The results suggest that vitamin D prescription was associated with a reduced incidence of hip fractures.

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Traduction de l'étude

La prescription de vitamine D était associée à une incidence plus faible de fractures de la hanche
Mitsutaka Yakabe Scientific Reports volume 13, numéro d'article : 12889 (2023)

Les patients atteints d'ostéoporose sont sujets aux fractures de fragilité. Les preuves des effets des formes actives de la vitamine D sur la prévention des fractures de la hanche sont insuffisantes. Nous avons examiné l'association entre la prescription de vitamine D et l'incidence de nouvelles fractures en utilisant les données des patients ostéoporotiques de la base de données nationale des réclamations d'assurance maladie du Japon. La période de suivi était de 3 ans après l'entrée. Les patients non traités ne se sont jamais vu prescrire de vitamine D pendant le suivi (n = 422 454) et les patients traités avaient un ratio de possession de médicaments à base de vitamine D  ≥ 0,5 à tous les moments (n = 169 774). L'appariement des scores de propension a été mis en œuvre sur ces groupes, produisant 105 041 paires, et par la suite, les groupes de contrôle et de traitement ont été établis et analysés.

L'incidence de nouvelles fractures était significativement plus faible dans le groupe de traitement par rapport au groupe témoin (6,25 % contre 5,69 %, risque relatif 0,936 [intervalle de confiance à 95 % 0,904–0,970], p < 0,001*). Selon le site, les fractures de la hanche ont significativement diminué (0,89 % contre 0,42 %, p < 0,001), mais pas les fractures vertébrales et radiales. L'analyse des sous-groupes par type de vitamine D a montré une incidence significativement plus faible de fractures totales uniquement avec l'alfacalcidol (risque relatif 0,676 [intervalle de confiance à 95 % 0,628–0,728], p < 0,001*).

Les résultats suggèrent que la prescription de vitamine D était associée à une incidence réduite de fractures de la hanche.

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Correlation of Rheumatoid Arthritis Disease Severity with Serum Vitamin D Levels
Padmapriya TV Clin Nutr August 25, 2023

Background and aim
Rheumatoid arthritis (RA) is an autoimmune disorder marked by characteristic inflammation of the small joints in addition to diverse systemic manifestations. Vitamin D has immunomodulatory properties, and its deficiency has a significant role in the clinical course of RA. The present research was conducted to study the correlation between serum vitamin D levels and disease activity scores in RA patients.
Methods
A cross sectional study was carried out on a sample of 50 patients presenting with RA. Disease activity was measured using Modified Disease Activity Score (DAS) criteria. Estimation of serum Vitamin D levels were done using the electrochemiluminescence method and values less than 20 ng/ml were considered as deficiency. Vitamin D levels were then correlated with disease activity scores.
Results
The Vitamin D deficiency was observed in 50% of the study population. Rheumatoid arthritis showed female preponderance in this study. Inflammatory markers such as C - reactive protein (CRP) levels and Erythrocyte Sedimentation Rate (ESR) did not differ with RA disease activity. More the number of large joints involved lesser were the vitamin D levels. There was an inverse correlation between Vitamin D levels and RA disease activity.
Conclusion
Vitamin D deficiency is significantly correlated with disease severity of RA. This study points to the importance of screening for deficit of vitamin D among RA patients and treat it as early as possible.

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Vitamin D insufficiency and disease risk in the elderly
Kiyoshi Tanaka Journal of Clinical Biochemist 2023

Vitamin D insufficiency, milder than deficiency, is common, and a risk of various diseases. Since vitamin D exert diverse actions, both skeletal and non-skeletal, its insufficiency is a risk of various diseases including osteoporosis, sarcopenia, cardiovascular disease, cancer, and even mortality. Regarding the association of vitamin D status and disease risk, a marked discrepancy exists between the results from the observational studies and intervention studies, mostly yielding the positive and negative results in the former and latter, respectively. Such inconsistency probably arises from methodological problems, of which the baseline vitamin D status would be the most important. Vitamin D intervention would be effective in the deficient/insufficient subjects, but not in sufficient subjects. Since the elderly subjects, especially the institutionalized people, are mostly vitamin D deficient/insufficient, they are likely to benefit from improvement of vitamin D status.

Vitamin insufficiency is a risk of various diseases, and correcting the vitamin status alone would reduce the risk of many diseases, and favorable to avoid the undesirable consequences of polypharmacy in the elderly. Additionally, disease prevention by nutritional improvement is cheap and free from side effects, and suited for the primary prevention of diseases.

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The Role of Vitamin D in Cardiovascular Diseases
by Man Hung Nutrients 2023, 15(16), 3547;

Cardiovascular diseases (CVD) are the leading cause of death in the United States. The previous literature demonstrates the importance of vitamin D for overall health, and a significant body of literature has examined the benefits of optimal serum 25-hydroxyvitamin D [25(OH)D] on cardiovascular health, but the results remain inconclusive. The objective of this study was to determine the association between reported CVD and [25(OH)D]. We utilized the 2015–2018 National Health and Nutrition Examination Survey and included adults aged 20 years and older (n = 9825). CVD was defined as having a stroke, heart attack, heart failure, or coronary heart disease.

Vitamin D status was categorized as a serum 25(OH)D deficiency at <30 nmol/L; insufficiency at 30 to 49.9 nmol/L; normal/optimal at 50 to 125 nmol/L; and adequacy at >125 nmol/L. Statistical analysis was performed using Chi-square tests, t-tests were conducted to investigate the differences in participant characteristics among those with CVD and without CVD, and regression models were used to explore the association between vitamin D levels and CVD status. We found 25(OH)D deficiency associated with CVD (Adjusted Odds Ratio (AOR) = 1.48; 95% CI = 1.11–1.98; p < 0.05). [25(OH)D] insufficiency was also associated with CVD (AOR = 1.28; 95% CI = 1.06–1.54; p < 0.05). The 25(OH)D adequacy was not associated with reported CVD.

For the prevention of CVD, healthcare professionals may recommend the use of vitamin D supplementation to improve cardiovascular health in adults while considering individual needs.

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Traduction de l'étude

Le rôle de la vitamine D dans les maladies cardiovasculaires
par Man Hung Nutrients 2023, 15(16), 3547 ;

Les maladies cardiovasculaires (MCV) sont la principale cause de décès aux États-Unis. La littérature précédente démontre l’importance de la vitamine D pour la santé globale, et un corpus important de littérature a examiné les bénéfices de la 25-hydroxyvitamine D [25(OH)D] sérique optimale sur la santé cardiovasculaire, mais les résultats restent peu concluants. L'objectif de cette étude était de déterminer l'association entre les maladies cardiovasculaires signalées et le [25(OH)D]. Nous avons utilisé l'Enquête nationale sur la santé et la nutrition de 2015 à 2018 et avons inclus des adultes âgés de 20 ans et plus (n = 9 825). La maladie cardiovasculaire était définie comme un accident vasculaire cérébral, une crise cardiaque, une insuffisance cardiaque ou une maladie coronarienne.

Le statut en vitamine D a été classé comme un déficit sérique en 25(OH)D <30 nmol/L ; insuffisance à 30 à 49,9 nmol/L ; normal/optimal entre 50 et 125 nmol/L ; et adéquation à >125 nmol/L. L'analyse statistique a été réalisée à l'aide de tests du chi carré, des tests t ont été effectués pour étudier les différences dans les caractéristiques des participants entre ceux atteints de MCV et ceux sans MCV, et des modèles de régression ont été utilisés pour explorer l'association entre les niveaux de vitamine D et le statut des maladies cardiovasculaires. Nous avons trouvé un déficit en 25(OH)D associé aux maladies cardiovasculaires (rapport de cotes ajusté (AOR) = 1,48 ; IC à 95 % = 1,11-1,98 ; p < 0,05). L'insuffisance en [25(OH)D] était également associée aux maladies cardiovasculaires (AOR = 1,28 ; IC à 95 % = 1,06–1,54 ; p < 0,05). L’adéquation du 25(OH)D n’était pas associée aux maladies cardiovasculaires signalées.

Pour la prévention des maladies cardiovasculaires, les professionnels de la santé peuvent recommander l’utilisation d’une supplémentation en vitamine D pour améliorer la santé cardiovasculaire des adultes tout en tenant compte des besoins individuels.

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Controlling Chronic Diseases and Acute Infections with Vitamin D Sufficiency
by Sunil J. Wimalawansa Nutrients 2023, 15(16), 3623;

Apart from developmental disabilities, the prevalence of chronic diseases increases with age especially in those with co-morbidities: vitamin D deficiency plays a major role in it. Whether vitamin D deficiency initiates and/or aggravates chronic diseases or vice versa is unclear. It adversely affects all body systems but can be eliminated using proper doses of vitamin D supplementation and/or safe daily sun exposure. Maintaining the population serum 25(OH)D concentration above 40 ng/mL (i.e., sufficiency) ensures a sound immune system, minimizing symptomatic diseases and reducing infections and the prevalence of chronic diseases. This is the most cost-effective way to keep a population healthy and reduce healthcare costs. Vitamin D facilitates physiological functions, overcoming pathologies such as chronic inflammation and oxidative stress and maintaining broader immune functions. These are vital to overcoming chronic diseases and infections. Therefore, in addition to following essential public health and nutritional guidance, maintaining vitamin D sufficiency should be an integral part of better health, preventing acute and chronic diseases and minimize their complications. Those with severe vitamin D deficiency have the highest burdens of co-morbidities and are more vulnerable to developing complications and untimely deaths.

Vitamin D adequacy improves innate and adaptive immune systems. It controls excessive inflammation and oxidative stress, generates antimicrobial peptides, and neutralizes antibodies via immune cells. Consequently, vitamin D sufficiency reduces infections and associated complications and deaths. Maintaining vitamin D sufficiency reduces chronic disease burden, illnesses, hospitalizations, and all-cause mortality. Vulnerable communities, such as ethnic minorities living in temperate countries, older people, those with co-morbidities, routine night workers, and institutionalized persons, have the highest prevalence of vitamin D deficiency—they would significantly benefit from vitamin D and targeted micronutrient supplementation. At least now, health departments, authorities, and health insurance companies should start assessing, prioritizing, and encouraging this economical, non-prescription, safe micronutrient to prevent and treat acute and chronic diseases. This approach will significantly reduce morbidity, mortality, and healthcare costs and ensure healthy aging.

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Osteoporosis and dermatoporosis: a review on the role of vitamin D
Fiammetta Romano Front. Endocrinol., 24 August 2023

Osteoporosis (OP) and Dermatoporosis (DP) are expressions of the aging process at the skin and bone levels, respectively. Both conditions are associated with increased morbidity for elderly people, and this requires necessary interventions. They share many common risk factors; among these, vitamin D (VD) deficiency appears to have a role. VD is involved in either disease with many mechanisms, among which immunomodulation.

VD deficiency has been linked to OP because it inhibits the body’s capacity to absorb calcium and maintain optimal bone health. Available evidence suggests that proper vitaminosis D also appears to be vital in preventing skin age-related issues. DP is often seen in elderly individuals, particularly those with long-term sun exposure and a history of chronic sun damage. VD deficiency can be linked to DP, since its involvement in collagen production, epidermal barrier function, inflammation regulation, wound healing, and sun protection. Aim of this review is to summarize the most updated existing evidence on the role of VD in the development of fragility syndromes such as DP and OP and the possible benefits of VD supplementation as a simple and harmful weapon against aging.