Table 1.
Risk factors for low Vit. D status.
| Groups of Risk Factors | Examples: Diseases, Conditions, Lifestyle Features |
|---|---|
| Musculoskeletal disorders | Rickets, osteoporosis, osteopenia, “bone pains”, muscle pain, myopathy, myodystrophy, recurrent (“low energy”) bone fractures, recurrent falls, bone deformities |
| Endocrine and metabolic diseases/conditions | Diabetes mellitus (type I and II), metabolic syndrome, obesity, overweight, hypo- and hyperparathyroidism, hypo- and hyperthyroidism, hypocalcemia, calciuria, phosphatemia, hypo- and hyperphosphatasia, phosphaturia, dyslipidemias |
| Increased demand for physiological reasons | Childhood, adolescence, pregnancy, breastfeeding |
| Malabsorption syndromes | Pancreatic exocrine insufficiency (old age, pancreatitis, type II diabetes, etc.), inflammatory bowel disease (Crohn’s disease, ulcerative colitis), cystic fibrosis, lactose intolerance, celiac disease, bariatric surgery |
| Diseases of the liver and bile ducts | Hepatic insufficiency, cirrhosis of the liver, cholestasis, hepatosteatosis |
| Kidney diseases | Renal insufficiency, chronic kidney disease (especially stages III–V), nephrotic syndrome |
| Respiratory diseases | Bronchial asthma, chronic obstructive pulmonary disease |
| Infectious diseases | Tuberculosis, recurrent respiratory infections |
| Systemic connective tissue diseases | Rheumatoid arthritis, systemic lupus erythematosus, dermatomyositis, fibromyalgia |
| Skin diseases | Atopic dermatitis, psoriasis |
| Diseases of the nervous system | Multiple sclerosis, Parkinson’s disease, dementia, cerebral palsy, autism |
| Decreased production of vitamin D3 in the skin | Older age (especially >70 years) Active protection against sun exposure (sunscreens, etc.) Cultural features (usual full-body clothing) Rare outdoor activities (work and leisure predominantly indoors; living in a care home) Increased air pollution (living in a city) Winter season (at medium latitudes) Dark-skinned (especially Africans) |
| Nutritional features | Veganism and other types of vegetarianism Allergy to cow’s milk Low-fat diet Insufficient magnesium intake Insufficient calcium intake |
| Long-term use of drugs | Antiepileptic drugs (e.g., valproate, phenytoin); antiretroviral drugs; glucocorticoids; systemic antifungal drugs; rifampin; bile acid sequestrants (cholestyramine); lipase inhibitors (orlistat) |
| Malignant neoplasms | Colon cancer, lymphatic system and blood cancers, breast cancer, ovarian cancer, prostate cancer |
| Granulomatous diseases | Sarcoidosis, histoplasmosis, coccidiomycosis, berylliosis |
| Mental illnesses | Depression, schizophrenia, anorexia nervosa |
| Cardiovascular diseases | Arterial hypertension, ischemic heart disease, heart failure |
| Others | Chronic fatigue syndrome Inpatient treatment (especially in the resuscitation and intensive care unit) Awaiting organ transplantation and post-transplant |