Vitamin d deficiency: universal risk factor for multifactorial diseases?

Curr Drug Targets. 2011 Jan 1;12(1):97-106.

de Borst MH, de Boer R, Stolk RP, Slaets JP, Wolffenbuttel BH, Navis G.

Departments of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. m.h.de.borst@int.umcg.nl.

In the Western world, the majority of morbidity and mortality are caused by multifactorial diseases. Some risk factors are related to more than one type of disease. These so-called universal risk factors are highly relevant to the population, as reduction of universal risk factors may reduce the prevalence of several types of multifactorial disease simultaneously. Vitamin D deficiency is traditionally seen as an etiological factor in bone disorders such as rickets and osteomalacia.

Recent studies also suggest a role for vitamin D deficiency in multifactorial disorders, including progressive renal function loss and cardiovascular disease; it is also a risk factor for frailty. The potentially pleiotropic effects of vitamin D analogues support the hypothesis that vitamin D deficiency is a universal risk factor . Here we review molecular actions of the vitamin D receptor (VDR), to identify mechanisms and pathways for vitamin D deficiency as a universal risk factor. To identify genes directly regulated by the VDR, we searched for genes containing vitamin D response elements (VDREs). A further refinement was made by selecting only VDRE-containing genes with documented modulation by VDR analogues in vivo.

Our search yielded a limited number of factors possibly related to pleiotropic effects of vitamin D, including growth factors, hormones, inflammatory factors and factors related to calcium homeostasis .

Results from observational, intervention and mechanistic studies indicate that vitamin D is a universal risk factor involved in diverse multifactorial conditions. Further exploration of the multifaceted actions of vitamin D may pave the way for disease-overriding intervention strategies. PMID: 20795934

Abstracts from this Special Issue of Current Drug Targets at VitaminDWiki

• Vitamin D: evolutionary, physiological and health perspectives Holick

• Vitamin d supplementation: a promising approach for the prevention and treatment of strokes

• Vitamin d biology in heart failure: molecular mechanisms and systematic review

• Vitamin d deficiency: universal risk factor for multifactorial diseases?

• Vitamin d in atherosclerosis, vascular disease, and endothelial function

• Editorial on Vitamin D deficiency– Current Drug topics – Jan 2011