New developments in our understanding of vitamin metabolism, action and treatment

Metabolism. 2019 Sep:98:112-120. doi: 10.1016/j.metabol.2019.06.010. Epub 2019 Jun 19.


Although vitamin D has been reported to have pleiotropic effects including effects on the immune system and on cancer progression, the principal action of vitamin D is the maintenance of calcium and phosphate homeostasis. The importance of vitamin D in this process is emphasized by the consequences of vitamin D deficiency which includes rickets in children and osteomalacia in adults. Vitamin D deficiency has also been reported to increase the risk of falls and osteoporotic fractures. Although vitamin D fortification of foods (including dairy products) has contributed to a marked decrease in rickets in the Western world, vitamin D deficiency in children and adults is still prevalent world-wide. This review summarizes new developments in our understanding of vitamin D endocrine system and addresses clinical syndromes related to abnormalities in vitamin D metabolism and action. In addition, the current understanding of the evaluation of vitamin D deficiency and sufficiency and recommendations for achieving vitamin D sufficiency are discussed.

Keywords: Bone; Calcium homeostasis; Fibroblast growth factor 23; Intestine; Kidney; Parathyroid hormone; Randomized controlled clinical trials; Vitamin D; Vitamin D metabolism.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Animals
  • Bone Density
  • Bone and Bones / metabolism
  • Humans
  • Vitamin D / metabolism*
  • Vitamin D / physiology
  • Vitamin D Deficiency / metabolism
  • Vitamin D Deficiency / therapy


  • Vitamin D