Deficiencia en vitamina Dun reto diagnóstico

Abstract

In the last years, the number of scientific publications related to vitamin D has remarkably increased. The possible role of vitamin D in the non-bone health outcomes has led to the establishment by most international scientific societies of a new and lower threshold of deficiency and it has generated great concern the prevalence of vitamin D deficiency. Many reports have suggested that vitamin D deficiency is common worldwide. The controversy as to what constitutes adequate or optimal serum vitamin D status is especially evident in pediatric population in which epidemiologic studies are scarce. The free vitamin D hypothesis suggests that this fraction of circulating vitamin D may be a better indicator of vitamin D status, so promoting a new and interesting line of research. In 2011, the Institute of Medicine published its Review “Dietary reference intakes for calcium and vitamin D” recognizing that, the serum 25OHD, although not validated as a substitute for health outcomes, could be used as an indexof vitamin D status, concluding that it is reasonable to consider 20 ng/mL as the threshold for most of people. “20” became the magic figure. But nowadays, the question becomes more complicated: what is the best marker of vitamin D status, total or free serum 25OHD? To find an answer rarely is the end of the search... fortunately.