Vitamin D inadequacy: The Italian picture

Abstract

Numerous epidemiological studies have assessed the prevalence of low serum 25-hydroxyvitamin D concentrations and have indicated that vitamin D inadequacy is a common problem in Italy, particularly in elderly women, and not only in in-patients with chronic disease or institutionalised subjects. There are important seasonal fluctuations in subjects living at home. Lower educational level, living in central Italy, smoking, and low intake of dairy products are associated with increased risk of vitamin D inadequacy. European and International studies have confirmed the high incidence of hypovitaminosis D in Italy, that appears unexpectedly more common than in northern European countries. Also, in Italy there is evidence that concentrations of 25-hydroxyvitamin D below 30 nmol/L is associated with secondary hyperparathyroidism, increased bone turnover, decreased bone mineral density at the hip, higher hip fracture prevalence, reduced muscular function and disability. The frequent finding of a high prevalence of vitamin D deficiency, in spite of the large amount of scientific data regarding the important role in the pathogenesis of skeletal and non-skeletal diseases, indicates that the treatments used up to now are insufficient or inadequate. A population-based strategy to correct this condition and new treatment methods with vitamin D that guarantee a better and long term compliance appear urgent. Preliminary experiences are heartening.