![]() ![]() Percentage 85% 15% 30% 20% 10% 0% 42% 50 nM 25 50 75 Serum 25(OH) D (nM)ġ5 Vitamin D deficiency predicts future hip fractureĨ00 women from WHI (7.1yr) 1665 men from MrOS (5.3yr) OR P for trend = 0.03 HR 1.6 ( ) per sd decrease in 25OHD Cauley AIM 2008 Cauley JBMR 2009ġ00,000 IU D3 4mthly British Doctors study Ipswich GP practice 5 yr Postal study 74.3 nM vs 53.4 nM Trivedi BMJ 2003ġ7 In pregnancy: Why and when? Normal trabecular bone N = 7441 PMO corrected for age, BMI, serum creatinine, and season Kuchuk JBMR 2009ġ3 Vitamin D and fracture LeBoff 2000 JAMAģ0 pmo admitted with a hip fracture LeBoff 2000 JAMA Institutions: M 80.7%, F 81.5% 0 nM > 100 nM Osteopenia Hyperparathyroidism Impaired intestinal calcium absorption Reduced bone volume with normal mineralization Rickets Males: 79.5% & 97.9% and respectively At 50 nmol/L: Private: M 50%, F 62.2%. UV 290 – 315 nm (297 peak) Converts provitamin D to previtamin D Warmth converts previtamin D to cholecalciferol vitamin D IF too much pre-vit d then uv breaks down to lumisterol4 and tachysterol3 25 vitamin D Ergocalciferol (D2) 1,25 vitamin D 1 ng/ml = 2.5 nM & 10 mcg = 400 IU 100 nM Osteopenia Secondary Institutions: M 80.7%, F 81.5%Ħ The past 1885 bone histology by Pommer 1918 Cod liver oil by Mellenbyįirst recognized in 1650 by Frances Glisson 1885 bone histology by Pommer 1918 Cod liver oil by Mellenby 1919 Artifical UV cure Huldschinskyħ Cholecalciferol (D3) Provitamin D vitamin D 25 vitamin D No pharmaceutical funding support for this talk In last five years received honoraria, travel and subsistence expenses from: Proctor and Gamble, Servier, Eli Lilly and NovartisĪt 50 nmol/L: Private: M 50%, F 62.2%. Oxfordshire PCT do not commission the use of high dose vitamin Dģ Why vitamin D Biology Clinical implications Rationale for therapy Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford Oxfordshire Osteoporosis Metabolic Bone Disease Service Nuffield Orthopaedic Centre, Oxford ![]() 1 Vitamin D M Kassim Javaid Norman Collisson Senior Research Fellow,
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