Purpose of review: Evidence has accumulated to show the prevalence of vitamin D insufficiency and deficiency in all age groups. Inadequate exposure to sunlight and to dietary sources contribute to the reemergence of musculoskeletal problems attributable to hypovitaminosis D.
Recent findings: There is a growing body of evidence for the alarming prevalence of vitamin D insufficiency and deficiency among healthy adolescents, adults, and elders. Several studies show increased prevalence of vitamin D deficiency among patients with fractures and patients with persistent musculoskeletal pain. Evidence suggests that genetic variations in the vitamin D receptor are associated with fracture risk. There has been a reconsideration of the range of normal laboratory values and recommended daily intake of vitamin D for different groups of individuals. New strategies are needed to identify individuals who would benefit from vitamin D treatments. Identification of vitamin D deficiency in patients with fractures and its correction require the education and cooperation of multiple specialists.
Summary: Physicians and orthopedic surgeons need to be alert to populations at risk of hypovitaminosis D. Immediate correction and maintenance of vitamin D adequacy require interactions of medical specialists.
aDepartment of Orthopedic Surgery, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts, USA; bDepartment of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts, USA
The authors’ work on vitamin D has been supported by grants from the United States Department of Defense.
Correspondence to Julie Glowacki, PhD, Orthopedic Research, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA
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