The need to reiterate the role of vitamin D, as a hormone, in supporting the health of a large slice of the population to reduce the risk of osteoporosis fractures and more has been at the center of the international scientific debate for some time. For this reason, the VI International Consensus on Vitamin D, scheduled in Florence these days, brings together over 30 of the world’s leading vitamin D experts. To coordinate the event, Andrea Giustina, head of endocrinology at the San Raffaele hospital and scientific coordinator of the Consensus of the Vita-Salute San Raffaele University of Milan and John Bilezikian, associate professor of internal medicine – Endocrinology, diabetes and metabolism at Columbia University in New York. Numerous topics will be dealt with during the work, including specialist focuses and vitamin D guidelines for bariatric surgery with an in-depth study on vitamin D and Covid-19. “The sixth international consensus on vitamin D focuses its work on the answers to three fundamental questions about vitamin D: why (give it)? When (give it)? How (give it)?”, Explains Giustina. “These are the questions we want to answer, reiterating that vitamin D is a hormone, and, therefore, not a simple supplement like all other vitamins and that it must therefore be supplemented when the body does not produce enough, according to precise indications and thresholds, which parameters to respect. “Vitamin D has proved to be useful and effective in various areas starting from the need for the association of this hormone in osteoporosis therapies to control the risk of fracture.” The point starting point – continues Giustina – is to measure vitamin D, in particular in countries with a high prevalence of hypovitaminosis D, such as Italy. osteoporosis or diabetes, and customize these thresholds with respect to the bone and extra-bone risk status of patients “. “As far as therapy is concerned – continues the expert – our position is that supplementation is necessary in all patients who have a real deficiency. This approach surpasses the position of the editorial of the New England Journal of Medicine ‘VitaL Findings – A decisive verdict on vitamin D supplementation ‘, published in the summer, which starts from unconvincing assumptions. The Vital study administers vitamin D to the general population indiscriminately, without first selecting patients who may actually need it. So much ado about nothing. – he observes – because it is clear, and we knew it, that giving vitamin D to everyone does not bring any benefit. From the clinical point of view and the necessary prudence of those who work in the field of medicine, we believe that the editorial in question should be intended as the start of a debate and not as a ‘verdict’. Study groups, scientific societies and health authorities will be active parties in this discussion which, m I hope, it will be prudent and rational, without necessarily simplifying in vitamin D: yes or no ”. But what kind of vitamin D should you take? To clarify which of the vitamin D molecules should be used – reads a note – it is necessary to start from physiology, because it is important to understand how molecules such as cholecalciferol, calcitriol and calcifediol are all forms of vitamin D found in the body. and in the blood, with different characteristics and uses. If calcifediol and calcitriol are useful molecules in some particular situations involving restricted populations, such as for example patients with hepatic or renal insufficiency, vitamin D for the general population is cholecalciferol because it is the molecule synthesized by the skin that is exposed to the rays. solar. “The problem – explains Giustina – is linked to physiology and is all attributable to the organism. In most cases, the body lacks cholecalciferol, because it is not produced by the skin. The risk of using more active vitamins D, such as calcitriol, when it is not necessary, is to overload the body. 2 – remember the note – have a very high prevalence of low vitamin D. Research is therefore focused on understanding whether hypovitaminosis D is an effect of Covid-19 or whether it is a precondition that makes people more prone to being affected by infection. “Vitamin D – underlines Giustina – could play a role above all in the prevention of Covid-19, as recent meta-analyzes reveal for other respiratory infections, while its use in the therapeutic field in association with anti-inflammatory and antiviral drugs is being study and with preliminary data that are not univocal “. Among the topics that will be addressed by the experts, the preparation of guidelines, expected by the end of the year, dedicated to the supplementation of vitamin D in obese or diabetic subjects undergoing bariatric surgery. “This argument – concludes the head of endocrinology of the San Raffaele in Milan – is important both because to date there are no scientific indications on the matter and because the number of anti-obesity bariatric surgery has progressively increased in number in recent years”.
Welcome! Log into your account
Recover your password
A password will be e-mailed to you.