title: The nonskeletal effects of vitamin D: an Endocrine Society scientific statement.
abstract: Significant controversy has emerged over the last decade concerning the effects of vitamin D on skeletal and nonskeletal tissues. The demonstration that the vitamin D receptor is expressed in virtually all cells of the body and the growing body of observational data supporting a relationship of serum 25-hydroxyvitamin D to chronic metabolic, cardiovascular, and neoplastic diseases have led to widespread utilization of vitamin D supplementation for the prevention and treatment of numerous disorders. In this paper, we review both the basic and clinical aspects of vitamin D in relation to nonskeletal organ systems. We begin by focusing on the molecular aspects of vitamin D, primarily by examining the structure and function of the vitamin D receptor. This is followed by a systematic review according to tissue type of the inherent biological plausibility, the strength of the observational data, and the levels of evidence that support or refute an association between vitamin D levels or supplementation and maternal/child health as well as various disease states. Although observational studies support a strong case for an association between vitamin D and musculoskeletal, cardiovascular, neoplastic, and metabolic disorders, there remains a paucity of large-scale and long-term randomized clinical trials. Thus, at this time, more studies are needed to definitively conclude that vitamin D can offer preventive and therapeutic benefits across a wide range of physiological states and chronic nonskeletal disorders.
authors.affiliation: Tufts University School of Medicine, Boston, MA 02111, USA. crofen@gmail.com
authors.forename: Clifford J
authors.initials: CJ
authors.lastname: Rosen
authors.forename: John S
authors.initials: JS
authors.lastname: Adams
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Bikle
authors.forename: Dennis M
authors.initials: DM
authors.lastname: Black
authors.forename: Marie B
authors.initials: MB
authors.lastname: Demay
authors.forename: JoAnn E
authors.initials: JE
authors.lastname: Manson
authors.forename: M Hassan
authors.initials: MH
authors.lastname: Murad
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Kovacs
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000818:Animals; D002318:Cardiovascular Diseases / Q000097:blood / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy; D019587:Dietary Supplements; D005260:Female; D047109:Fetal Development / Q000187:drug effects; D006801:Humans; D008297:Male; D051379:Mice; D009140:Musculoskeletal Diseases / Q000097:blood / Q000188:drug therapy; D009369:Neoplasms / Q000097:blood / Q000188:drug therapy; D009765:Obesity / Q000097:blood / Q000188:drug therapy; D011247:Pregnancy; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D051381:Rats; D018167:Receptors, Calcitriol / Q000378:metabolism; D012867:Skin / Q000187:drug effects; D014807:Vitamin D / Q000097:blood / Q000378:metabolism* / Q000627:therapeutic use*
chemical_list: D018167:Receptors, Calcitriol; D014807:Vitamin D