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Vitamin D: not just the bone. Evidence for beneficial pleiotropic extraskeletal effects

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Abstract

Vitamin D is a fat-soluble vitamin and a steroid hormone that plays a central role in maintaining calcium-phosphorus and bone homeostasis in close interaction with parathyroid hormone, acting on its classical target tissues, namely, bone, kidney, intestine, and parathyroid glands. However, vitamin D endocrine system regulates several genes (about 3 % of the human genome) involved in cell differentiation, cell-cycle control, and cell function and exerts noncalcemic/pleiotropic effects on extraskeletal target tissues, such as immune and cardiovascular system, pancreatic endocrine cells, muscle, and adipose tissue. Several studies have demonstrated the role of vitamin D supplementation in the prevention/treatment of various autoimmune diseases and improvement of glucose metabolism, muscle, and adipose tissue function. Hence, this review aims to elucidate the effects of vitamin D on extraskeletal target tissues and to investigate the potential therapeutic benefit of vitamin D supplementation among a broad group of pathological conditions, especially with regard to metabolic and autoimmune diseases. In addition, we focused on the best daily intakes and serum levels of vitamin D required for extraskeletal benefits which, even if still controversial, appear to be higher than those widely accepted for skeletal effects.

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Abbreviations

VD3 :

Vitamin D3

7-DHC:

7-Dehydrocholesterol

25(OH)D3 :

25-Hydroxyvitamin D3

1,25(OH)2D3 :

1,25-Dihydroxyvitamin D3

DBP:

Vitamin D binding protein

VDR:

Vitamin D receptor

PTH:

Parathyroid hormone

BMD:

Bone mineral density

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Authors and Affiliations

  1. Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele Pisana, via di Val Cannuta 247, 00166, Rome, Italy

    Massimiliano Caprio & Caterina Mammi

  2. Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy

    Massimiliano Caprio

  3. Unit of Endocrinology and Metabolic Diseases, Department of Systems Medicine, CTO A. Alesini Hospital, ASL Roma 2, University Tor Vergata, Rome, Italy

    Marco Infante, Matilde Calanchini & Andrea Fabbri

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  1. Massimiliano Caprio
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Caprio, M., Infante, M., Calanchini, M. et al. Vitamin D: not just the bone. Evidence for beneficial pleiotropic extraskeletal effects. Eat Weight Disord 22, 27–41 (2017). https://doi.org/10.1007/s40519-016-0312-6

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