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J Clin Res Pediatr Endocrinol. 2019 Sep 3;11(3):220-226. doi: 10.4274/jcrpe.galenos.2019.2019.0007. Epub 2019 Feb 14.

Pitfalls with Vitamin D Research in Musculoskeletal Disorders and Recommendations on How to Avoid Them

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Nemours Children’s Hospital and Specialty Care, Department of Orthopedics and Sports Medicine, Florida, USA
Nemours Children’s Specialty Care, Department of Orthopedic Surgery, Florida, USA
Washington University Faculty of Medicine, Department of Orthopaedic Surgery, 1 Children’s Place, Missouri, USA
Nemours Children’s Specialty Care, Department of Endocrinology, Florida, USA
Children’s Hospital of Philadelphia, Center for Bone Health, Division of Endocrinology and Diabetes, Pennsylvania, USA


Reports suggesting that vitamin D may have extraskeletal roles have renewed interest in vitamin D research and stimulated publication of an increasing number of new studies each year. These studies typically assess vitamin D status by measuring the blood concentration of 25-hydroxyvitamin D [25(OH)D], the principal circulating metabolite of vitamin D. Unfortunately, variations in assay format, inconsistency in interpreting 25(OH)D concentrations, cohort bias (age, body mass index, race, season of measurements etc.) and failure to measure critical variables needed to interpret study results, makes interpreting results and comparing studies difficult. Further, variation in reporting results (reporting mean values vs. percent of the cohort that is deficient, no clear statement as to clinical relevance of effect size, etc.) further limits interstudy analyses. In this paper, we discuss many common pitfalls in vitamin D research. We also provide recommendations on avoiding these pitfalls and suggest guidelines to enhance consistency in reporting results.


Vitamin D; 25-hydroxyvitamin D; deficiency

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