There is increasing evidence that, in addition to the well-known effects on musculoskeletal
health, vitamin D status may be related to a number of non-skeletal diseases. An international
expert panel formulated recommendations on vitamin D for clinical practice, taking
into consideration the best evidence available based on published literature today.
In addition, where data were limited to smaller clinical trials or epidemiologic studies,
the panel made expert-opinion based recommendations.
Twenty-five experts from various disciplines (classical clinical applications, cardiology,
autoimmunity, and cancer) established draft recommendations during a 2-day meeting.
Thereafter, representatives of all disciplines refined the recommendations and related
texts, subsequently reviewed by all panelists. For all recommendations, panelists
expressed the extent of agreement using a 5-point scale.
Recommendations were restricted to clinical practice and concern adult patients with
or at risk for fractures, falls, cardiovascular or autoimmune diseases, and cancer.
The panel reached substantial agreement about the need for vitamin D supplementation
in specific groups of patients in these clinical areas and the need for assessing
their 25-hydroxyvitamin D (25(OH)D) serum levels for optimal clinical care. A target
range of at least 30 to 40 ng/mL was recommended. As response to treatment varies
by environmental factors and starting levels of 25(OH)D, testing may be warranted
after at least 3 months of supplementation. An assay measuring both 25(OH)D(2) and
25(OH)D(3) is recommended. Dark-skinned or veiled individuals not exposed much to
the sun, elderly and institutionalized individuals may be supplemented (800 IU/day)
without baseline testing.
Copyright 2010 Elsevier B.V. All rights reserved.