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Review
. 2014 Jan;2(1):76-89.
doi: 10.1016/S2213-8587(13)70165-7. Epub 2013 Dec 6.

Vitamin D Status and Ill Health: A Systematic Review

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Review

Vitamin D Status and Ill Health: A Systematic Review

Philippe Autier et al. Lancet Diabetes Endocrinol. .

Abstract

Low serum concentrations of 25-hydroxyvitamin D (25[OH]D) have been associated with many non-skeletal disorders. However, whether low 25(OH)D is the cause or result of ill health is not known. We did a systematic search of prospective and intervention studies that assessed the effect of 25(OH)D concentrations on non-skeletal health outcomes in individuals aged 18 years or older. We identified 290 prospective cohort studies (279 on disease occurrence or mortality, and 11 on cancer characteristics or survival), and 172 randomised trials of major health outcomes and of physiological parameters related to disease risk or inflammatory status. Investigators of most prospective studies reported moderate to strong inverse associations between 25(OH)D concentrations and cardiovascular diseases, serum lipid concentrations, inflammation, glucose metabolism disorders, weight gain, infectious diseases, multiple sclerosis, mood disorders, declining cognitive function, impaired physical functioning, and all-cause mortality. High 25(OH)D concentrations were not associated with a lower risk of cancer, except colorectal cancer. Results from intervention studies did not show an effect of vitamin D supplementation on disease occurrence, including colorectal cancer. In 34 intervention studies including 2805 individuals with mean 25(OH)D concentration lower than 50 nmol/L at baseline supplementation with 50 μg per day or more did not show better results. Supplementation in elderly people (mainly women) with 20 μg vitamin D per day seemed to slightly reduce all-cause mortality. The discrepancy between observational and intervention studies suggests that low 25(OH)D is a marker of ill health. Inflammatory processes involved in disease occurrence and clinical course would reduce 25(OH)D, which would explain why low vitamin D status is reported in a wide range of disorders. In elderly people, restoration of vitamin D deficits due to ageing and lifestyle changes induced by ill health could explain why low-dose supplementation leads to slight gains in survival.

Comment in

  • Vitamin D: chasing a myth?
    Lancet Diabetes Endocrinol. 2014 Jan;2(1):1. doi: 10.1016/S2213-8587(13)70164-5. Epub 2013 Dec 6. Lancet Diabetes Endocrinol. 2014. PMID: 24622652 No abstract available.
  • Vitamin D status and ill health.
    Holick MF, Grant WB. Holick MF, et al. Lancet Diabetes Endocrinol. 2014 Apr;2(4):273-4. doi: 10.1016/S2213-8587(14)70044-0. Lancet Diabetes Endocrinol. 2014. PMID: 24703040 No abstract available.
  • Vitamin D status and ill health.
    Giovannucci E. Giovannucci E. Lancet Diabetes Endocrinol. 2014 Apr;2(4):273. doi: 10.1016/S2213-8587(14)70017-8. Lancet Diabetes Endocrinol. 2014. PMID: 24703041 No abstract available.
  • Vitamin D status and ill health.
    Naughton D, Petroczi A. Naughton D, et al. Lancet Diabetes Endocrinol. 2014 Apr;2(4):274-5. doi: 10.1016/S2213-8587(14)70048-8. Lancet Diabetes Endocrinol. 2014. PMID: 24703042 No abstract available.
  • Vitamin D status and ill health--author's reply.
    Autier P, Boniol M, Pizot C, Mullie P. Autier P, et al. Lancet Diabetes Endocrinol. 2014 Apr;2(4):275-6. doi: 10.1016/S2213-8587(14)70049-X. Lancet Diabetes Endocrinol. 2014. PMID: 24703043 No abstract available.
  • Vitamin D status and ill health.
    Garland CF, Gorham ED, Hofflich HE, Mohr SB. Garland CF, et al. Lancet Diabetes Endocrinol. 2014 Apr;2(4):e10. doi: 10.1016/S2213-8587(14)70042-7. Lancet Diabetes Endocrinol. 2014. PMID: 24703054 No abstract available.
  • Vitamin D status and ill health.
    Macdonald HM, Wood AD, Fraser WD, Simpson WG. Macdonald HM, et al. Lancet Diabetes Endocrinol. 2014 Apr;2(4):e8-9. doi: 10.1016/S2213-8587(14)70047-6. Lancet Diabetes Endocrinol. 2014. PMID: 24703056 No abstract available.
  • Vitamin D status and ill health.
    Feelisch M, Gorman S, Weller RB. Feelisch M, et al. Lancet Diabetes Endocrinol. 2014 Apr;2(4):e8. doi: 10.1016/S2213-8587(14)70043-9. Lancet Diabetes Endocrinol. 2014. PMID: 24703057 No abstract available.
  • Vitamin D status and ill health.
    Garcia de Tena J, Abejón-López L, Hernández-Gutiérrez C, Bernal-Bello D, Rodríguez-Zapata M. Garcia de Tena J, et al. Lancet Diabetes Endocrinol. 2014 Apr;2(4):e9-10. doi: 10.1016/S2213-8587(14)70046-4. Lancet Diabetes Endocrinol. 2014. PMID: 24703058 No abstract available.
  • Vitamin D status and ill health.
    Harvey NC, Cooper C. Harvey NC, et al. Lancet Diabetes Endocrinol. 2014 Apr;2(4):e9. doi: 10.1016/S2213-8587(14)70045-2. Lancet Diabetes Endocrinol. 2014. PMID: 24703059 No abstract available.
  • Controlled trials of vitamin D, causality and type 2 statistical error.
    Gillie O. Gillie O. Public Health Nutr. 2016 Feb;19(3):409-14. doi: 10.1017/S1368980014002304. Epub 2014 Nov 5. Public Health Nutr. 2016. PMID: 25370294

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