Honig D (2019) The Power of Letting Go Stanford Social Innovation Review Winter 2019

Study under review: Randomized clinical trial in vitamin D-deficient adults comparing replenishment with oral vitamin D3 with narrow-band UV type B lite: effects on cholesterol and the transcriptional profiles of skin and claret

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Introduction

Vitamin D is the 'sunshine vitamin' that nosotros brand in our skin when exposed to ultraviolet radiation, traditionally from sunlight merely also from modernistic engineering similar sunbeds ^[1]. As depicted in Figure 1, vitamin D is made when UVB light ranging betwixt 280-320 nanometers in the lite spectrum transforms a cholesterol-similar precursor in the skin. Vitamin D is then released into the bloodstream, where it travels to the liver and kidney for farther metabolism into its active forms, 25(OH)D and ane,25(OH)_iiD. Vitamin D can as well be obtained from the nutrition in the same grade that is released by skin into the bloodstream.

Figure 1: How vitamin D is synthesized using UV light

The metabolite, 25(OH)D, is the most normally used blood marker of vitamin D status. Although levels for optimal health remain debated, the Endocrine Society states that 25(OH)D levels should exist higher up 30 nanograms per milliliter (ng/ml) for full general health, with less than 20 ng/ml considered a deficiency and twenty-29 ng/ml considered an insufficiency. Observational evidence ^{[2] [iii]} has suggested that American adults with 25(OH)D concentrations less than twenty ng/ml take significantly higher LDL-c, lower HDL-c, and college triglycerides than people above 30 ng/ml. However, a meta-assay ^[4] of randomized controlled trials suggests that vitamin D repletion through oral vitamin D supplementation does non significantly influence these claret lipids.

Although untested, information technology is possible that oral vitamin D supplements and sunlight-derived vitamin D have different metabolic effects. This would explain the uncoupling between observational testify and controlled trials regarding vitamin D's consequence on blood lipids. Appropriately, the study under review sought to compare the outcome of vitamin D repletion on claret lipids, accomplished with the use of either oral supplements or UVB light exposure treatments.

Vitamin D deficiency (less than 20 ng/mL) is associated with a more harmful claret lipid profile than seen in people with healthy levels (more than 30 ng/mL), but interventions correcting deficiency with vitamin D supplementation have shown that blood lipids remain unchanged. Since vitamin D is naturally made in the skin upon exposure to UVB radiations, the study nether review sought to test if claret lipids would be changed when vitamin D deficiency was corrected with the use of UVB light treatments, compared to oral vitamin D supplementation.

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