Determinazione e supplementazione della vitamina D: come, a chi e perché

In the last decades, in addition to improvements in the understanding of pathophysiology, mechanisms of action and role of vitamin D in bone metabolism, significant advancements in analytical methods and assay standardization have been reported. Advances in biochemical assessment, therapeutic goals for vitamin D nutrition for optimal bone health, and the association of vitamin D deficiency with non-skeletal disease have revived interest in this hormone. In addition, many papers, meta-analyses and recommendations on the clinical value of this vitamin and its supplementation to correct severe vitamin D deficiency have been published. However, particularly after the release of the “Determina” AIFA, it seems to be useful to clarify some essential variables of the vitamin D measurement (regarding both analytical and post-analytical issues), as well as current evidence on its supplementation. In addition, taking into consideration the interconnection between vitamin D, Parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23), a discussion on both analytical issues and clinical usefulness of their measurement will be discussed.