Nieuw licht op vitamine D

Herwaardering van een essentieel prohormoon
Stand van zaken
Jos P.M. Wielders, Frits A.J. Muskiet en Albert van de Wiel

Shedding new light on vitamin D - Reassessment of an essential prohormone

Conflict of interest: none declared. Financial support: none declared.

  • Vitamin-D deficiency is no longer to be seen only as a cause of osteomalacia, rickets and osteoporosis. There is a causal relationship with muscle function and also with the functioning of our immune system.

  • Furthermore, vitamin-D deficiency is associated with a higher risk of autoimmune diseases and several forms of malignancy, such as prostate, colon and breast cancer.

  • Optimal serum concentration is under discussion which has already led to modification of the recommendations on vitamin-D suppletion.

  • At present, European consensus on 25-hydroxyvitamin-D serum concentrations seems to be a minimum of 50 nmol/l and a target of 75 nmol/l.

  • The majority of the elderly and of non-Western immigrants are deficient or severely deficient in vitamin D and correction of such a deficiency with bolus therapy should be considered.

  • Awareness of a vitamin-D deficiency is needed in unexplained complaints of muscle weakness or muscle pain, and in the risk groups, such as the elderly, non-Western immigrants, the chronically ill, indoor living and institutionalized,, those who habitually use sun protection cream, and severely obese patients.