Supplementation, Optimal Status, and Analytical Determination of Vitamin D: Where are we standing in 2012?
Jean-Claude Souberbielle and Etienne Cavalier
Abstractfrequent in countries where food is so diversified and easily available. In fact, vitamin d is not a vitamin stricto sensu as it is mainly synthesized in the skin under the action of uvb rays, while its food sources are scarce. furthermore, uvb rays are absent during a marked part of the year at latitudes greater than 35-40°, while pollution and cloud cover reduce the number of uvb reaching the earth, and many factors such as age, skin pigmentation, covering clothes, sun creams reduce the capacity of the skin to synthesize vitamin d3. Vitamin d must be hydroxylated to form 1,25dihydroxyvitamin d (1,25oh2d), the active metabolite. As 1,25oh2d is released into the bloodstream and binds to a receptor present in several distant tissues, it may be considered as a hormone, vitamin d being thus a pre-prohormone. In the present article, we review briefly the metabolism and various effects of vitamin d as well as the vitamin d assays and vitamin d treatments. We define vitamin d deficiency/insufficiency considering separately the population and the patient level and propose our opinion about which patients may benefit from vitamin d testing.
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