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Nutrients
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Therapeutic Use and Challenges of Vitamin D
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Therapeutic Use and Challenges of Vitamin D

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Micronutrients and Human Health".

Deadline for manuscript submissions: 15 January 2025 | Viewed by 2118

Special Issue Editors

Dr. Gerrit Steffen Maier

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Guest Editor
Rehazentrum am Meer, Bad Zwischenahn, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
Interests: vitamin D; osteoporosis; bone metabolism; diet; health
Special Issues, Collections and Topics in MDPI journals
Dr. Tyler Barker

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Guest Editor
1. Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA
2. Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
Interests: osteoarthritis; cachexia; vitamin D; cytokines; systemic inflammation; precision nutrition
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Vitamin D, a fat-soluble secosteroid, is crucial for calcium absorption, bone health, and immune function. Therapeutically, it is used to treat and prevent conditions like osteoporosis, rickets, and certain autoimmune diseases. It is also being investigated for potential benefits in cardiovascular health, cancer prevention, and mental health disorders such as depression. Vitamin D’s role in modulating the immune response has gained attention in managing chronic diseases and infections, including respiratory illnesses.

However, several challenges complicate its therapeutic use. Optimal dosing is contentious due to varying individual needs and the interplay of factors like skin pigmentation, geographic location, and lifestyle affecting synthesis from sunlight. Deficiency is common, especially in populations with limited sun exposure or dietary intake, leading to varied guidelines for supplementation. Excessive intake risks hypercalcemia, characterized by elevated blood calcium levels, causing vascular and tissue calcification.

The bioavailability of vitamin D can also be influenced by factors such as obesity, as the vitamin is sequestered in fat tissues, reducing its active form in circulation. Additionally, interactions with medications, such as corticosteroids and anticonvulsants, can affect vitamin D metabolism, complicating its therapeutic management. Addressing these challenges requires personalized treatment strategies and ongoing research to refine dosing guidelines and understand long-term impacts.

Dr. Gerrit Steffen Maier
Dr. Tyler Barker
Guest Editors

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • osteology
  • vitamin D
  • hypovitaminosis D
  • osteoporosis
  • orthopedics
  • bone health

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Published Papers (3 papers)

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Research

10 pages, 1893 KiB  
Article
Prevalence and Associated Risk Factors for Hypovitaminosis D in Patients Scheduled for Primary Total Knee Arthroplasty in Germany
by Tizian Heinz, Miledi Hoxha, Philip Mark Anderson, Axel Jakuscheit, Manuel Weißenberger, Martin Lüdemann, Dominik Rak, Maximilian Rudert and Konstantin Horas
Nutrients 2024, 16(23), 3991; https://doi.org/10.3390/nu16233991 - 21 Nov 2024
Viewed by 256
Abstract
Objective: Several studies have reported a high prevalence of hypovitaminosis D in orthopedic patients. The purpose of this prospective observational study was to report on the prevalence of hypovitaminosis D in patients scheduled for elective primary total knee arthroplasty (TKA) and its associated [...] Read more.
Objective: Several studies have reported a high prevalence of hypovitaminosis D in orthopedic patients. The purpose of this prospective observational study was to report on the prevalence of hypovitaminosis D in patients scheduled for elective primary total knee arthroplasty (TKA) and its associated risk factors. Methods: In this monocentric cohort study, 25(OH) vitamin D serum levels were measured in 687 consecutive patients undergoing primary total knee arthroplasty (TKA) over a period of twelve months. Vitamin D levels were classified into deficiency (<20 ng/mL), insufficiency (20–29 ng/mL), and sufficiency (≥30 ng/mL). The study assessed the association of vitamin D levels with demographic and clinical factors, including age, sex, BMI, smoking status, and season of measurement. Statistical analyses included chi-square tests, correlation analyses, and multiple linear regression to identify significant predictors of vitamin D levels. Results: The cohort had a mean age of 67.70 ± 8.95 years and a mean BMI of 31.00 ± 5.71 kg/m2. Collectively, 33.9% of patients were vitamin D deficient, a further 32.9% were insufficient, and only 33.2% were sufficient. Vitamin D levels varied significantly with the season and were associated with obesity and smoking. Specifically, there was a small significant inverse correlation between BMI and vitamin D levels (r = −0.17, p < 0.01). Furthermore, regular nicotine abuse was linked to lower vitamin D levels (r = 0.14, p < 0.01). Multiple linear regression analysis reveals that age, BMI, nicotine abuse, and season were small significant predictors of preoperative vitamin D levels (R2 = 0.15, adjusted R2 = 0.12). A total of 121 (17.61%) patients reported routine vitamin D intake prior to surgery. Supplementing patients had a significantly higher mean serum vitamin D level and a significant reduction in the mean length of in-hospital stay (p < 0.01). Conclusions: The prevalence of vitamin D insufficiency and deficiency in patients undergoing elective primary TKA is alarmingly high. In ongoing efforts to optimize the efficacy and outcome of the TKA procedure, orthopedic surgeons should be advised to strongly implement the role of perioperative vitamin D levels in their routine practice. Full article
(This article belongs to the Special Issue Therapeutic Use and Challenges of Vitamin D)
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14 pages, 933 KiB  
Article
Effect of Vitamin D Supplementation on Inflammatory Markers in Obese Patients with Acute and Chronic Orthopedic Conditions
by Michał Gawryjołek, Michał Wiciński, Maria Zabrzyńska, Jakub Ohla and Jan Zabrzyński
Nutrients 2024, 16(21), 3735; https://doi.org/10.3390/nu16213735 - 31 Oct 2024
Viewed by 649
Abstract
Numerous studies have shown that vitamin D may play an important role in modulating the inflammatory process. This study aimed to evaluate the effect of vitamin D supplementation on inflammatory markers in patients with orthopedic disorders and obesity. Thirty-three obese subjects were included [...] Read more.
Numerous studies have shown that vitamin D may play an important role in modulating the inflammatory process. This study aimed to evaluate the effect of vitamin D supplementation on inflammatory markers in patients with orthopedic disorders and obesity. Thirty-three obese subjects were included in the study and were divided into two groups based on their medical condition: acute orthopedic diseases and chronic orthopedic diseases. Inclusion criteria for the research included age 18–75 years, BMI > 30 kg/m2, vitamin D deficiency, and no previous vitamin D supplementation. Samples were collected before and after 3 months of 4000 IU/day vitamin D supplementation. The study used enzyme-linked immunosorbent assay (ELISA) and measured serum levels of markers such as chitinase-3-like protein 1 (YKL-40), interleukin 6 (IL-6), interleukin 17 (IL-17), tumor necrosis factor (TNF-α), and adiponectin. After 3 months of vitamin D supplementation, a statistically significant increase in vitamin D and IL-17 levels was observed in the group with acute orthopedic diseases. Similarly, after supplementation, a statistically significant increase in vitamin D, IL-6 and TNF-α levels was observed in the group with chronic orthopedic diseases. Moreover, after vitamin D supplementation, statistically significantly higher adiponectin levels were observed in the chronic orthopedic group than in the acute orthopedic group. Despite high-dose vitamin D supplementation, inflammatory markers increased in acute and chronic orthopedic conditions. Based on our study, vitamin D does not reduce inflammation in patients with orthopedic conditions and obesity. Full article
(This article belongs to the Special Issue Therapeutic Use and Challenges of Vitamin D)
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11 pages, 898 KiB  
Article
Prevalence and Risk Factors of Vitamin D Deficiency in Patients Scheduled to Undergo Revision Arthroplasty of the Hip, Knee and Shoulder—Data from a Single-Centre Analysis
by Konstantin Horas, Miledi Hoxha, Tizian Heinz, Axel Jakuscheit, Kilian List, Gerrit S. Maier, Manuel Weißenberger and Maximilian Rudert
Nutrients 2024, 16(18), 3060; https://doi.org/10.3390/nu16183060 - 11 Sep 2024
Viewed by 894
Abstract
Vitamin D is crucial for ideal bone health and good muscle function, both essential requirements for successful joint arthroplasty. Hence, vitamin D deficiency has recently been identified as a predictor of poorer outcomes in patients scheduled to undergo total joint arthroplasty (TJA). Moreover, [...] Read more.
Vitamin D is crucial for ideal bone health and good muscle function, both essential requirements for successful joint arthroplasty. Hence, vitamin D deficiency has recently been identified as a predictor of poorer outcomes in patients scheduled to undergo total joint arthroplasty (TJA). Moreover, there is ample evidence today that vitamin D deficiency is associated with periprosthetic joint infection. Yet, vitamin D deficiency seems to be frequent in patients who are scheduled to undergo TJA. However, the prevalence of hypovitaminosis D in patients who require revision arthroplasty (rTJA) is largely unknown. Further, risk factors of vitamin D deficiency in these patients remain to be elucidated. For this reason, the primary objective of this study was to assess the vitamin D status of patients scheduled to undergo rTJA of the hip, knee and shoulder. The secondary objective was to identify potential risk factors for hypovitaminosis D in these patients. Serum vitamin D [25(OH)D] levels of 249 patients who were scheduled for rTJA were assessed over a period of twelve months at a high-volume TJA centre. Collectively, 23% of patients reported a routine intake of vitamin D supplements (58/249). Notably, 81% of patients (155/191) who did not report a routine vitamin D intake presented with insufficient vitamin D levels (below 30 ng/mL), while only 19% of patients (36/191) had sufficient vitamin D levels. Of those who reported a routine vitamin D intake, 75% (43/58) had sufficient vitamin D levels, while 25% (15/58) showed insufficient vitamin D status. Patients who did not routinely take any vitamin D supplements had significantly lower vitamin D levels compared to patients who reported regular vitamin D intake (19.91 ng/mL vs. 40.66 ng/mL). Further, BMI and nicotine abuse were identified as potential risk factors for hypovitaminosis D in patients without vitamin D supplementation. Moreover, the season of spring seems to be a risk factor in patients with vitamin D supplementation, while age itself did not appear to be a significant risk factor for low vitamin D levels. In conclusion, we found an alarmingly high rate of vitamin D deficiency in patients scheduled to undergo rTJA. Notably, reported routine vitamin D supplementation showed significantly increased serum vitamin D levels compared to patients with no reported supplementation. Due to the high prevalence of vitamin D deficiency, we believe that vitamin D status should routinely be assessed in patients who are scheduled to undergo rTJA. Full article
(This article belongs to the Special Issue Therapeutic Use and Challenges of Vitamin D)
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