Annals of Epidemiology
Volume 19, Issue 2 , Pages 73-78, February 2009

Vitamin D Status: Measurement, Interpretation, and Clinical Application

  • Michael F. Holick, PhD, MD

      Affiliations

    • Corresponding Author InformationAddress correspondence to: Michael F. Holick, Boston University School of Medicine, 715 Albany Street, M-1013, Boston, MA 02118. Tel.: 617-638-4545; fax: 617-638-8882.

Department of Medicine, Section of Endocrinology, Nutrition, and Diabetes, Vitamin D, Skin and Bone Research Laboratory, Boston University Medical Center, Boston, MA

Received 14 May 2007; accepted 17 December 2007. published online 10 March 2008.

Vitamin D, the sunshine vitamin, is now recognized not only for its importance in promoting bone health in children and adults but also for other health benefits, including reducing the risk of chronic diseases such as autoimmune diseases, common cancer, and cardiovascular disease. Vitamin D made in the skin or ingested in the diet is biologically inert and requires 2 successive hydroxylations first in the liver on carbon 25 to form 25-hydroxyvitamin D [25(OH)D], and then in the kidney for a hydroxylation on carbon 1 to form the biologically active form of vitamin D, 1,25-dihydroxyvitamin D [1,25(OH)2D]. With the identification of 25(OH)D and 1,25(OH)2D, methods were developed to measure these metabolites in the circulation. Serum 25(OH)D is the barometer for vitamin D status. Serum 1,25(OH)2D provides no information about vitamin D status and is often normal or even increased as the result of secondary hyperparathyroidism associated with vitamin D deficiency. Most experts agree that 25(OH)D of <20 ng/mL is considered to be vitamin D deficiency, whereas a 25(OH)D of 21-29 ng/mL is considered to be insufficient. The goal should be to maintain both children and adults at a level >30 ng/mL to take full advantage of all the health benefits that vitamin D provides.

Key Words: Vitamin D, 25-Hydroxyvitamin D, Sunlight, Parathyroid Hormone, Cancer

Selected Abbreviations and Acronyms: 25(OH)D, 25-hydroxyvitamin D, 1,25(OH)2D, 1,25 dihydroxyvitamin D, PTH, parathyroid hormone

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 Editor's note: With this issue, we initiate a symposium on the epidemiology of vitamin D. Our Guest Editor, Dr. Cedric Garland, has overseen the project and will provide an overview and commentary at its completion. The current contribution deal with measurement and clinical interpretation of Vitamin D, and with some aspects of the relationship of Vitamin D and cancer. Subsequent issues will continue the discussion of cancer, with attention to the risks of vitamin D and perspectives on its use for cancer prevention.

 This work was supported in part by NIH grants M01RR00533 and AR36963 and the UV Foundation.

PII: S1047-2797(08)00002-1

doi:10.1016/j.annepidem.2007.12.001

Annals of Epidemiology
Volume 19, Issue 2 , Pages 73-78, February 2009

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