Vitamin D, menopause, and aging: quo vadis?

Abstract

Menopause and aging are associated with changes in circulating gonadal steroid hormones, insulin sensitivity, body composition, and also lifestyle and social coordinates. Vitamin D status influences different metabolic adjustments, aside from calcium–phosphorus and bone metabolism. The main blood marker used to measure endogenous vitamin D status is 25-hydroxyvitamin D. Aging is associated with increases in serum parathyroid hormone and alkaline phosphatase, and a decrease of serum calcium, phosphorus, and vitamin D metabolites. 25-Hydroxyvitamin D status is also influenced by the circannual rhythm of sun irradiation. Results of clinical association studies have not correlated with intervention trials, experimental studies, and/or meta-analyses regarding the role of vitamin D on different outcomes in women during their second half of life and the vitamin D supplementation dose needed to improve clinical endpoints. Discordant results have been related to the method used to measure vitamin D, the studied population (i.e., sociodemographics and ethnicity), study designs, and biases of analyses. Vitamin D supplementation with cholecalciferol or calcifediol may improve some metabolic variables and clinical outcomes in young postmenopausal and older women. Studies seem to suggest that calcifediol may have some advantages over other forms of vitamin D supplementation. Further studies are needed to define interventions with supplements and effective food fortification.

摘要

绝经和衰老与循环性腺甾体激素、胰岛素敏感性、身体成分以及生活方式和社会地位的变化有关。维生素D的状态除了影响钙磷和骨骼代谢外, 还会影响不同的代谢调节。用于评估内源性维生素D水平的主要血液标志物是25-羟基维生素D。衰老与血清甲状旁腺激素和碱性磷酸酶的增加以及血清钙、磷和维生素D代谢产物的减少有关。25-羟基维生素D的水平也受阳光照射的昼夜节律的影响。临床相关研究的结果与关于维生素D对女性后半生不同结局的影响以及改善临床终点所需的维生素D补充剂量的干预性试验、实验研究和/或meta分析没有关联。不一致的结果与用于检测维生素D的方法、研究人群（即社会人口统计学和种族）、研究设计以及分析偏倚有关。维生素D补充胆钙化醇或骨化二醇可能改善绝经后和年老女性的某些代谢参数和临床结局。研究似乎表明, 骨化二醇可能比其他形式的维生素D补充剂有一些优势。需要进一步的研究来确定补充剂和有效食品强化的干预措施。

Keywords:

• Vitamin D
• 25-hydroxyvitamin D
• menopause
• aging
• cholecalciferol
• calcifediol
• ergocalciferol

Potential conflict of interest

No potential conflict of interest was reported by the authors.

Additional information

Funding

This review was partially supported by the Sistema de Investigación y Desarrollo and Vice-Rectorado de Investigación & Postgrado of Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador [grant No. SIU-318–853-2014 (The Omega II, Women’s Health Project 2014) provided to Peter Chedraui].