Factors in human vitamin D nutrition and in the production and cure of classical rickets

Our studies have provided evidence for an action of vitamin D on renal tubular phosphate reabsorption in healing rickets

T. C. B. Stamp

2005

Scholarcy highlights

  • Vitamin D reaches the body from two totally dissimilar sources, first by cutaneous synthesis under the action of ultraviolet light and secondly in the diet
  • Vitamin D from dietary and cutaneous sources is metabolized in liver to form 25-hydroxy-vitamin D, the major circulating form of the vitamin
  • In a small series of Caucasian patients with nutritional osteomalacia reported by previous research, vitamin D intakes were all less than 1 . 8 pg/d
  • Estimated vitamin D intake may bear little relationship to nutritional status and, even in the denigrated British climate, summer sunshine may contribute the major part of our vitamin D provided we achieve average exposure
  • Lcvels rose steadily to the high normal range. These findings indicated that neither skin pigmentation nor high-phytate diets interfere with the treatment of rickets and osteomalacia by ultraviolet light, and suggest that they may not be important as a cause
  • Since the hypocalcaemic effect of raised plasma P levels is enhanced in metabolic bone disease, indicating preferential precipitation of Ca and P within bone in these conditions, present results suggest that healing of rickets with vitamin D may be due to the combined action of enhanced intestinal Ca transport and enhanced renal tubular P reabsorption, the P retention producing hypocalcaemia and further enhancing calcification
  • This intake should be optimal in normal subjects, and other factors may clearly determine vitamin D deficiency in patients with chronic renal failure

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