Diagnosis of disorders of vitamin D-metabolism and osteomalacia

Clin Lab. 2008;54(11-12):451-9.

Abstract

Vitamin D deficiency is very common in Germany because the synthesis of Vitamin D in the skin depends on exposure to radiation from sunlight (ultraviolet light type B). In Central Europe, vitamin D synthesis in skin is significantly diminished during the 6-month winter period. Whereas a slight lack of vitamin D (vitamin D insufficiency) results in osteoporosis (decrease in bone mass), a major lack of vitamin D (vitamin D deficiency) leads to osteomalacia, a mineralization defect of the bone. Before the skeletal consequences of vitamin D deficiency take place, neuromuscular functional disorders may already occur. An early diagnosis of vitamin D deficiency is important. In this respect, laboratory abnormalities are especially of great importance. For example, an increase in serum parathyroid hormone concentration is a very early sign. The presence of vitamin D deficiency can be proven by measuring the serum concentration of 25-hydroxyvitamin D. During the treatment of vitamin D deficiency with drugs consisting of vitamin D (vitamin D supplements), the measurement of serum 25-hydroxyvitamin D is very useful for monitoring of therapy and follow up.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Diagnosis, Differential
  • Humans
  • Osteomalacia / diagnosis*
  • Osteomalacia / drug therapy
  • Osteomalacia / etiology
  • Osteomalacia / pathology
  • Parathyroid Hormone / blood
  • Ultraviolet Therapy
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D / metabolism*
  • Vitamin D / therapeutic use
  • Vitamin D Deficiency / diagnosis*
  • Vitamin D Deficiency / drug therapy
  • Vitamin D Deficiency / etiology
  • Vitamin D Deficiency / pathology

Substances

  • Parathyroid Hormone
  • Vitamin D
  • 25-hydroxyvitamin D