Hypovitaminosis D is a prevalent disorder in developing countries. Clinical manifestations of hypovitaminosis D include musculoskeletal disorders, such as nonspecific muscle pain, poor muscle strength and low BMD, as well as nonmusculoskeletal disorders, such as an increased risk of respiratory infections, diabetes mellitus and possibly cardiovascular diseases. In developing countries, the prevalence of hypovitaminosis D varies widely by and within regions; prevalence ranges between 30–90%, according to the cut-off value used within specific regions, and is independent of latitude. A high prevalence of the disorder exists in China and Mongolia, especially in children, of whom up to 50% are reported to have serum 25-hydroxyvitamin D levels <12.5 nmol/l. Despite ample sunshine throughout the year, one-third to one-half of individuals living in Sub-Saharan Africa and the Middle East have serum 25-hydroxyvitamin D levels <25 nmol/l, according to studies published in the past decade. Hypovitaminosis D is also prevalent in children and the elderly living in Latin America. Risk factors for hypovitaminosis D in developing countries are similar to those reported in Western countries and include extremes of age, female sex, winter season, dark skin pigmentation, malnutrition, lack of sun exposure, a covered clothing style and obesity. Clinical trials to assess the effect of vitamin D supplementation on classical and nonclassical clinical outcomes in developing countries are needed.
Hypovitaminosis D is a widespread disorder in developing countries, regardless of their latitude
The disorder is highly prevalent in China, Mongolia, Sub-Saharan Africa, the Middle East and Latin America, especially in children, the elderly and women
Risk factors are similar to those reported in Western countries and include extremes of age, female sex, winter season, low socioeconomic status, malnutrition, covered clothing style and dark skin
Clinical manifestations of hypovitaminosis D are not limited to musculoskeletal disorders, but may also include an increased risk of respiratory infections, diabetes mellitus and possibly cardiovascular diseases
Public health-awareness campaigns, as well as food fortification with vitamin D are efficacious and affordable means to prevent vitamin D deficiency
Clinical trials are needed to assess the effect of vitamin D supplementation on the burden of both communicable and noncommunicable diseases in developing countries
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Tavera-Mendoza, L. E. & White, J. H. Cell defenses and the sunshine vitamin. Sci. Am. 297, 68–70 (2007).
Mithal, A. et al. Global vitamin D status and determinants of hypovitaminosis D. Osteoporos. Int. 20, 1807–1820 (2009).
Holick, M. F. Vitamin D deficiency. N. Engl. J. Med. 357, 266–281 (2007).
DeLuca, H. F. Overview of general physiologic features and functions of vitamin D. Am. J. Clin. Nutr. 80, 1689S–1696S (2004).
Dawson-Hughes, B. et al. Estimates of optimal vitamin D status. Osteoporos. Int. 16, 713–716 (2005).
Holick, M. F. 25-OH-vitamin D assays. J. Clin. Endocrinol. Metab. 90, 3128–3129 (2005).
Lips, P. Vitamin D status and nutrition in Europe and Asia. J. Steroid Biochem. Mol. Biol. 103, 620–625 (2007).
Papandreou, D., Malindretos, P., Karabouta, Z. & Rousso, I. Possible health implications and low vitamin D status during childhood and adolescence: An updated mini review. Int. J. Endocrinol. 2010, 472173 (2010).
Kachondham, Y., Dhanamitta, S., Oyunbileg, M. & Brown, L. Child health and nutritional status in Ulaanbaatar, Mongolia: a preliminary assessment. Asia Pac. J. Public Health 6, 226–232 (1992–1993).
Ganmaa, D. et al. Effects of vitamin D fortified milk on vitamin D status in Mongolian school age children. Asia Pac. J. Clin. Nutr. 17, 68–71 (2008).
Strand, M. A. et al. Diagnosis of rickets and reassessment of prevalence among rural children in Northern China. Pediatr. Int. 49, 202–209 (2007).
Specker, B. L. et al. Prospective study of vitamin D supplementation and rickets in China. J. Pediatr. 120, 733–739 (1992).
Du, X. et al. Vitamin D deficiency and associated factors in adolescent girls in Beijing. Am. J. Clin. Nutr. 74, 494–500 (2001).
Fraser, D. R. Vitamin D-deficiency in Asia. J. Steroid Biochem. Mol. Biol. 89–90, 491–495 (2004).
Kruger, M. C. et al. The effect of a fortified milk drink on vitamin D status and bone turnover in post-menopausal women from South East Asia. Bone 46, 759–767 (2010).
Rahman, S. A., Chee, W. S., Yassin, Z. & Chan, S. P. Vitamin D status among postmenopausal Malaysian women. Asia Pac. J. Clin. Nutr. 13, 255–260 (2004).
Green, T. J. et al. Vitamin D status and its association with parathyroid hormone concentrations in women of child-bearing age living in Jakarta and Kuala Lumpur. Eur. J. Clin. Nutr. 62, 373–378 (2008).
Setiati, S. Vitamin D status among Indonesian elderly women living in institutionalized care units. Acta Med. Indones. 40, 78–83 (2008).
Bruyère, O., Malaise, O., Neuprez, A., Collette, J. & Reginster, J. Y. Prevalence of vitamin D inadequacy in European postmenopausal women. Curr. Med. Res. Opin. 23, 1939–1944 (2007).
Napiórkowska, L. et al. Prevalence of low serum vitamin D concentration in an urban population of elderly women in Poland. Pol. Arch. Med. Wewn. 119, 699–703 (2009).
Andiran, N., Yordam, N. & Ozön, A. Risk factors for vitamin D deficiency in breast-fed newborns and their mothers. Nutrition 18, 47–50 (2002).
Ozkan, B. et al. Prevalence of vitamin D deficiency rickets in the eastern part of Turkey. Eur. J. Pediatr. 168, 95–100 (2009).
Olmez, D., Bober E., Buyukgebiz, A. & Cimrin, D. The frequency of vitamin D insufficiency in healthy female adolescents. Acta Paediatr. 95, 1266–1269 (2006).
Sarikaya, S. et al. Effect of underground working on vitamin D levels and bone mineral densities in coal miners: a controlled study. J. Int. Med. Res. 34, 362–366 (2006).
Durán, P., Mangialavori, G., Biglieri, A., Kogan, L. & Abeyá Gilardon, E. [Nutrition status in Argentinean children 6 to 72 months old: results from the National Nutrition and Health Survey (ENNyS)]. Arch. Argent Pediatr. 107, 397–404 (2009).
Oliveri, M. B., Ladizesky, M., Mautalen, C. A., Alonso, A. & Martinez, L. Seasonal variations of 25 hydroxyvitamin D and parathyroid hormone in Ushuaia (Argentina), the southernmost city of the world. Bone Miner. Res. 20, 99–108 (1993).
Oliveri, B. et al. High prevalence of vitamin D insufficiency in healthy elderly people living at home in Argentina. Eur. J. Clin. Nutr. 58, 337–342 (2004).
Portela, M. L. et al. Comparative 25-OH-vitamin D level in institutionalized women older than 65 years from two cities in Spain and Argentina having a similar solar radiation index. Nutrition 26, 283–289 (2010).
González, G. et al. High prevalence of vitamin D deficiency in Chilean healthy postmenopausal women with normal sun exposure: additional evidence for a worldwide concern. Menopause 14, 455–461 (2007).
Peters, B. S., dos Santos, L. C., Fisberg, M., Wood, R. J. & Martini, L. A. Prevalence of vitamin D insufficiency in Brazilian adolescents. Ann. Nutr. Metab. 54, 15–21 (2009).
Premaor, M. O. et al. Hypovitaminosis D and secondary hyperparathyroidism in resident physicians of a general hospital in southern Brazil. J. Endocrinol. Invest. 31, 991–995 (2008).
Scalco, R., Premaor, M. O., Fröehlich, P. E. & Furlanetto, T. W. High prevalence of hypovitaminosis D and secondary hyperparathyroidism in elders living in nonprofit homes in South Brazil. Endocrine 33, 95–100 (2008).
Okonofua, F. et al. Rickets in Nigerian children: a consequence of calcium malnutrition. Metabolism 40, 209–213 (1991).
Pfitzner, M. A. et al. Absence of vitamin D deficiency in young Nigerian children. J. Pediatr. 133, 740–744 (1998).
Lulseged, S. & Fitwi, G. Vitamin D deficiency rickets: socio-demographic and clinical risk factors in children seen at a referral hospital in Addis Ababa. East Afr. Med. J. 76, 457–461 (1999).
Manaseki-Holland, S., Zulf Mughal, M., Bhutta, Z. & Qasem Shams, M. Vitamin D status of socio-economically deprived children in Kabul, Afghanistan. Int. J. Vitam. Nutr. Res. 78, 16–20 (2008).
Fischer, P. R. et al. Nutritional rickets without vitamin D deficiency in Bangladesh. J. Trop. Pediatr. 45, 291–293 (1999).
Islam, M. Z. et al. Vitamin D deficiency: a concern in premenopausal Bangladeshi women of two socio-economic groups in rural and urban region. Eur. J. Clin. Nutr. 56, 51–56 (2002).
Islam, M. Z., Akhtaruzzaman, M. & Lamberg-Allardt, C. Hypovitaminosis D is common in both veiled and nonveiled Bangladeshi women. Asia Pac. J. Clin. Nutr. 15, 81–87 (2006).
Atiq, M., Suria, A., Nizami, S. Q. & Ahmed, I. Vitamin D status of breastfed Pakistani infants. Acta Paediatr. 87, 737–740 (1998).
Zuberi, L. M., Habib, A., Haque, N. & Jabbar, A. Vitamin D deficiency in ambulatory patients. J. Pak. Med. Assoc. 58, 482–484 (2008).
Sachan, A. et al. High prevalence of vitamin D deficiency among pregnant women and their newborns in northern India. Am. J. Clin. Nutr. 81, 1060–1064 (2005).
Marwaha, R. K. et al. Vitamin D and bone mineral density status of healthy schoolchildren in Northern India. Am. J. Clin. Nutr. 82, 477–482 (2005).
Goswami, R. et al. Prevalence and significance of low 25-hydroxyvitamin D concentrations in healthy subjects in Delhi. Am. J. Clin. Nutr. 72, 472–475 (2000).
Lips, P. et al. The prevalence of vitamin D inadequacy amongst women with osteoporosis: an international epidemiological investigation. J. Intern. Med. 260, 245–254 (2006).
Saadi, H. F. et al. Predictors and relationships of serum 25 hydroxyvitamin D concentration with bone turnover markers, bone mineral density, and vitamin D receptor genotype in Emirati women. Bone 39, 1136–1143 (2006).
Salek, M. et al. Vitamin D deficiency among pregnant women and their newborns in Isfahan, Iran. Exp. Clin. Endocrinol. Diabetes 116, 352–356 (2008).
Bassir, M. et al. Vitamin D deficiency in Iranian mothers and their neonates: a pilot study. Acta Paediatr. 90, 577–579 (2001).
Kazemi, A., Sharifi, F., Jafari, N. & Mousavinasab, N. High prevalence of vitamin D deficiency among pregnant women and their newborns in an Iranian population. J. Womens Health (Larchmt) 18, 835–839 (2009).
Rabbani, A. et al. Vitamin D insufficiency among children and adolescents living in Tehran, Iran. J. Trop. Pediatr. 55, 189–191 (2009).
Hashemipour, S. et al. Vitamin D deficiency and causative factors in the population of Tehran. BMC Public Health 25, 38 (2004).
El-Hajj Fuleihan, G. et al. Hypovitaminosis D in healthy schoolchildren. Pediatrics 107, E53 (2001).
El-Hajj Fuleihan, G. et al. Effect of vitamin D replacement on musculoskeletal parameters in school children: a randomized controlled trial. J. Clin. Endocrinol. Metab. 91, 405–412 (2006).
Fuleihan, G. E. & Deeb, M. Hypovitaminosis D in a sunny country. N. Engl. J. Med. 340, 1840–1841 (1999).
Gannagé-Yared, M. H., Chemali, R., Yaacoub, N. & Halaby, G. Hypovitaminosis D in a sunny country: relation to lifestyle and bone markers. J. Bone Miner. Res. 15, 1856–1862 (2000).
Arabi, A. et al. Hypovitaminosis D osteopathy: is it mediated through PTH, lean mass, or is it a direct effect? Bone 39, 268–275 (2006).
Mishal, A. A. Effects of different dress styles on vitamin D levels in healthy young Jordanian women. Osteoporos. Int. 12, 931–935 (2001).
Gharaibeh, M. A. & Stoecker, B. J. Assessment of serum 25(OH)D concentration in women of childbearing age and their preschool children in Northern Jordan during summer. Eur. J. Clin. Nutr. 63, 1320–1326 (2009).
Lawson, D. E. et al. Etiology of rickets in Egyptian children. Hum. Nutr. Clin. Nutr. 41, 199–208 (1978).
Baroncelli, G. I. et al. Rickets in the Middle East: role of environment and genetic predisposition. J. Clin. Endocrinol. Metab. 93, 1743–1750 (2008).
Allali, F. et al. High prevalence of hypovitaminosis D in Morocco: relationship to lifestyle, physical performance, bone markers, and bone mineral density. Semin. Arthritis Rheum. 38, 444–451 (2009).
Meddeb, N. et al. Vitamin D deficiency in Tunisia. Osteoporos. Int. 16, 180–183 (2005).
Misra, A. & Khurana, L. Obesity and the metabolic syndrome in developing countries. J. Clin. Endocrinol. Metab. 93 (Suppl. 1), S9–S30 (2008).
Wortsman, J., Matsuoka, L. Y., Chen, T. C., Lu, Z. & Holick, M. F. Decreased bioavailability of vitamin D in obesity. Am. J. Clin. Nutr. 72, 690–693 (2000).
Masood, S. H. & Iqbal, M. P. Prevalence of vitamin D deficiency in South Asia. Pak. J. Med. Sci. 24, 891–897 (2008).
Clemens, T. L., Adams, J. S., Henderson, S. L. & Holick, M. F. Increased skin pigment reduces the capacity of skin to synthesize vitamin D3. Lancet 9, 74–76 (1982).
Lo, C. W., Paris, P. W. & Holick, M. F. Indian and Pakistani immigrants have the same capacity as Caucasians to produce vitamin D in response to ultraviolet irradiation. Am. J. Clin. Nutr. 44, 683–685 (1986).
Laing, C. J. & Fraser, D. R. Changes with malnutrition in the concentration of plasma vitamin D binding protein in growing rats. Br. J. Nutr. 88, 133–139 (2002).
Agarwal, K. S. et al. The impact of atmospheric pollution on vitamin D status of infants and toddlers in Delhi, India. Arch. Dis. Child. 87, 111–113 (2002).
Arabi, A., Mahfoud, Z., Zahed, L., El-Onsi, L. & El-Hajj Fuleihan, G. Effect of age, gender and calciotropic hormones on the relationship between vitamin D receptor gene polymorphisms and bone mineral density in the Lebanese. Eur. J. Clin. Nutr. 64, 383–391 (2010).
Javaid, M. K. et al. Maternal vitamin D status during pregnancy and childhood bone mass at age 9 years: a longitudinal study. Lancet 367, 36–43 (2006).
Pawley, N. & Bishop, N. J. Prenatal and infant predictors of bone health: the influence of vitamin D. Am. J. Clin. Nutr. 80, 1748S–1751S (2004).
Bischoff-Ferrari, H. A. et al. Effect of vitamin D on falls: a meta-analysis. JAMA 291, 1999–2006 (2004).
Collins, D., Jasani, C., Fogelman, I. & Swaminathan, R. Vitamin D and bone mineral density. Osteoporos. Int. 8, 110–114 (1998).
Badsha, H., Daher, M. & Ooi Kong, K. Myalgias or non-specific muscle pain in Arab or Indo-Pakistani patients may indicate vitamin D deficiency. Clin. Rheumatol. 28, 971–973 (2009).
Foo, L. H. et al. Low vitamin D status has an adverse influence on bone mass, bone turnover, and muscle strength in Chinese adolescent girls. J. Nutr. 139, 1002–1007 (2009).
Arabi, A., Baddoura, G. & El-Hajj Fuleihan, G. PTH and not vitamin D predicts age-related bone loss in the elderly: A prospective population based study. Am. Soc. Bone Miner. Res. 23 (Suppl. 1), M178 (2008).
Akcakus, M. et al. The relationship between birthweight, 25-hydroxyvitamin D concentrations and bone mineral status in neonates. Ann. Trop. Paediatr. 26, 267–275 (2006).
Hosseinpanah, F., Rambod, M., Hossein-Nejad, A., Larijani, B. & Azizi, F. Association between vitamin D and bone mineral density in Iranian postmenopausal women. J. Bone Miner. Metab. 26, 86–92 (2008).
Nagpal, S., Na, S. & Rathnachalam, R. Noncalcemic actions of vitamin D receptor ligands. Endocr. Rev. 26, 662–687 (2005).
Berman, S. Epidemiology of acute respiratory infections in children of developing countries. Rev. Infect. Dis. 13 (Suppl. 6), S454–S462 (1991).
Savitha, M. R. et al. Modifiable risk factors for acute lower respiratory tract infections. Indian J. Pediatr. 74, 477–482 (2007).
Liu, P. T., Stenger, S., Tang, D. H. & Modlin, R. L. Cutting edge: vitamin D-mediated human antimicrobial activity against Mycobacterium tuberculosis is dependent on the induction of cathelicidin. J. Immunol. 15, 2060–2063 (2007).
Liu, P. T. et al. Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science 311, 1770–1773 (2006).
Gibney, K. B. et al. Vitamin D deficiency is associated with tuberculosis and latent tuberculosis infection in immigrants from sub-Saharan Africa. Clin. Infect. Dis. 46, 443–446 (2008).
Wayse, V., Yousafzai, A., Mogale, K. & Filteau, S. Association of subclinical vitamin D deficiency with severe acute lower respiratory infection in Indian children under 5 years. Eur. J. Clin. Nutr. 58, 563–567 (2004).
Nnoaham, K. E. & Clarke, A. Low serum vitamin D levels and tuberculosis: a systematic review and meta-analysis. Int. J. Epidemiol. 37, 113–119 (2008).
Karatekin, G., Kaya, A., Salihoglu, O., Balci, H. & Nuhoglu, A. Association of subclinical vitamin D deficiency in newborns with acute lower respiratory infection and their mothers. Eur. J. Clin. Nutr. 63, 473–477 (2009).
El-Radhi, A. S., Majeed, M., Mansor, N. & Ibrahim, M. High incidence of rickets in children with wheezy bronchitis in a developing country. J. R. Soc. Med. 75, 884–887 (1982).
Selmi, C. & Tsuneyama, K. Nutrition, geoepidemiology, and autoimmunity. Autoimmun. Rev. 9, A267–A270 (2010).
Mody, G. M. & Cardiel, M. H. Challenges in the management of rheumatoid arthritis in developing countries. Best Pract. Res. Clin. Rheumatol. 22, 621–641 (2008).
McAlindon, T. E. et al. Relation of dietary intake and serum levels of vitamin D to progression of osteoarthritis of the knee among participants in the Framingham Study. Ann. Intern. Med. 125, 353–359 (1996).
Merlino, L. A. et al. Vitamin D intake is inversely associated with rheumatoid arthritis: results from the Iowa Women's Health Study. Arthritis Rheum. 50, 72–77 (2004).
Hyppönen, E., Läärä, E., Reunanen, A., Järvelin, M. R. & Virtanen, S. M. Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet 358, 1500–1503 (2001).
Ruderman, N., Chisholm, D., Pi-Sunyer, X. & Schneider, S. The metabolically obese, normal-weight individual revisited. Diabetes 47, 699–713 (1998).
Pittas, A. G., Lau, J., Hu, F. B. & Dawson-Hughes, B. The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J. Clin. Endocrinol. Metab. 92, 2017–2029 (2007).
Chiu, K. C., Chu, A., Go, V. L. & Saad, M. F. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am. J. Clin. Nutr. 79, 820–825 (2004).
Boucher, B. J., Mannan, N., Noonan, K., Hales, C. N. & Evans, S. J. Glucose intolerance and impairment of insulin secretion in relation to vitamin D deficiency in east London Asians. Diabetologia 38, 1239–1245 (1995).
Nimitphong, H., Chanprasertyothin, S., Jongjaroenprasert, W. & Ongphiphadhanakul, B. The association between vitamin D status and circulating adiponectin independent of adiposity in subjects with abnormal glucose tolerance. Endocrine 36, 205–210 (2009).
Gannagé-Yared, M. H. et al. Vitamin D in relation to metabolic risk factors, insulin sensitivity and adiponectin in a young Middle-Eastern population. Eur. J. Endocrinol. 160, 965–971 (2009).
Bonakdaran, S. & Varasteh, A. R. Correlation between serum 25 hydroxyvitamin D3 and laboratory risk markers of cardiovascular diseases in type 2 diabetic patients. Saudi Med. J. 30, 509–514 (2009).
Farrant, H. J. et al. Vitamin D insufficiency is common in Indian mothers but is not associated with gestational diabetes or variation in newborn size. Eur. J. Clin. Nutr. 63, 646–652 (2009).
Witham, M. D., Nadir, M. A. & Struthers, A. D. Effect of vitamin D on blood pressure: a systematic review and meta-analysis. J. Hypertens. 27, 1948–1954 (2009).
Rejnmark, L., Vestergaard, P., Heickendorff, L. & Mosekilde, L. Simvastatin does not affect vitamin D status, but low vitamin D levels are associated with dyslipidemia: results from a randomized, controlled trial. Int. J. Endocrinol. 2010, 957174 (2010).
Stanner, S. New thinking about diet and cardiovascular disease. J. Fam. Health Care 16, 71–74 (2006).
Dobnig, H. et al. Independent association of low serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels with all-cause and cardiovascular mortality. Arch. Intern. Med. 168, 1340–1349 (2008).
John, W. G., Noonan, K., Mannan, N. & Boucher, B. J. Hypovitaminosis D is associated with reductions in serum apolipoprotein A-I but not with fasting lipids in British Bangladeshis. Am. J. Clin. Nutr. 82, 517–522 (2005).
World Health Organisation (WHO). Cancer: Diet and Physical Activity's Impact [online], (2010).
Gorham, E. D. et al. Vitamin D and prevention of colorectal cancer. J. Steroid Biochem. Mol. Biol. 97, 179–194 (2005).
Hanchette, C. L. & Schwartz, G. G. Geographic patterns of prostate cancer mortality. Evidence for a protective effect of ultraviolet radiation. Cancer 70, 2861–2869 (1992).
Hines, S. L., Jorn, H. K., Thompson, K. M. & Larson, J. M. Breast cancer survivors and vitamin D: a review. Nutrition 26, 255–262 (2010).
El Saghir, N. S. et al. Trends in epidemiology and management of breast cancer in developing Arab countries: a literature and registry analysis. Int. J. Surg. 5, 225–233 (2007).
Parkin, D. M., Bray, F., Ferlay, J. & Pisani, P. Global cancer statistics, 2002. CA Cancer J. Clin. 55, 74–108 (2005).
Bischoff-Ferrari, H. A. et al. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA 293, 2257–2264 (2005).
El-Hajj Fuleihan, G. In Vitamin D: Physiology, Molecular Biology and Clinical Applications 2nd edn Ch. 24 (ed. Holick, M.) 469–494 (Humana Press, New Jersey, New York, 2009).
Zipitis, C. S. & Akobeng, A. K. Vitamin D supplementation in early childhood and risk of type 1 diabetes: a systematic review and meta-analysis. Arch. Dis. Child. 93, 512–517 (2008).
Sugden, J. A., Davies, J. I., Witham, M. D., Morris, A. D. & Struthers, A. D. Vitamin D improves endothelial function in patients with type 2 diabetes mellitus and low vitamin D levels. Diabetes Med. 25, 320–325 (2008).
Autier, P. & Gandini, S. Vitamin D supplementation and total mortality: a meta-analysis of randomized controlled trials. Arch. Intern. Med. 167, 1730–1737 (2007).
Margolis, K. L. et al. Effect of calcium and vitamin D supplementation on blood pressure: the Women's Health Initiative Randomized Trial. Hypertension 52, 847–855 (2008).
de Boer, I. H. et al. Calcium plus vitamin D supplementation and the risk of incident diabetes in the Women's Health Initiative. Diabetes Care 31, 701–707 (2008).
Li-Ng, M. et al. A randomized controlled trial of vitamin D3 supplementation for the prevention of symptomatic upper respiratory tract infections. Epidemiol. Infect. 137, 1396–1404 (2009).
Wejse, C. et al. Vitamin D as supplementary treatment for tuberculosis: a double-blind, randomized, placebo-controlled trial. Am. J. Respir. Crit. Care Med. 179, 843–850 (2009).
Li, X. et al. Protective effects of 1-alpha-hydroxyvitamin D3 on residual beta-cell function in patients with adult-onset latent autoimmune diabetes (LADA). Diabetes Metab. Res. Rev. 25, 411–416 (2009).
The authors declare no competing financial interests.
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Arabi, A., El Rassi, R. & El-Hajj Fuleihan, G. Hypovitaminosis D in developing countries—prevalence, risk factors and outcomes. Nat Rev Endocrinol 6, 550–561 (2010). https://doi.org/10.1038/nrendo.2010.146
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