The 6th International Conference, "Controversies in Vitamin D," was convened to discuss controversial topics, such as vitamin D metabolism, assessment, actions, and supplementation. Novel insights into vitamin D mechanisms of action suggest links with conditions that do not depend only on reduced solar exposure or diet intake and that can be detected with distinctive noncanonical vitamin D metabolites. Optimal 25-hydroxyvitamin D (25(OH)D) levels remain debated. Varying recommendations from different societies arise from evaluating different clinical or public health approaches. The lack of assay standardization also poses challenges in interpreting data from available studies, hindering rational data pooling and meta-analyses. Beyond the well-known skeletal features, interest in vitamin D's extraskeletal effects has led to clinical trials on cancer, cardiovascular risk, respiratory effects, autoimmune diseases, diabetes, and mortality. The initial negative results are likely due to enrollment of vitamin D-replete individuals. Subsequent post hoc analyses have suggested, nevertheless, potential benefits in reducing cancer incidence, autoimmune diseases, cardiovascular events, and diabetes. Oral administration of vitamin D is the preferred route. Parenteral administration is reserved for specific clinical situations. Cholecalciferol is favored due to safety and minimal monitoring requirements. Calcifediol may be used in certain conditions, while calcitriol should be limited to specific disorders in which the active metabolite is not readily produced in vivo. Further studies are needed to investigate vitamin D effects in relation to the different recommended 25(OH)D levels and the efficacy of the different supplementary formulations in achieving biochemical and clinical outcomes within the multifaced skeletal and extraskeletal potential effects of vitamin D.

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关于维生素 D 状态评估和补充的共识声明：原因、时间和方式。


第六届国际会议“维生素D的争议”召开，讨论维生素D代谢、评估、行动和补充等争议话题。对维生素 D 作用机制的新见解表明，维生素 D 与某些条件的联系不仅仅取决于阳光照射或饮食摄入的减少，而且可以通过独特的非典型维生素 D 代谢物来检测。最佳 25-羟基维生素 D (25(OH)D) 水平仍存在争议。不同社会的不同建议源于对不同临床或公共卫生方法的评估。检测标准化的缺乏也给解释现有研究的数据带来了挑战，阻碍了合理的数据汇集和荟萃分析。除了众所周知的骨骼特征之外，人们对维生素 D 的骨骼外效应的兴趣还引发了针对癌症、心血管风险、呼吸系统影响、自身免疫性疾病、糖尿病和死亡率的临床试验。最初的阴性结果可能是由于招募了维生素 D 充足的个体。然而，随后的事后分析表明，它在降低癌症发病率、自身免疫性疾病、心血管事件和糖尿病方面具有潜在的好处。口服维生素 D 是首选途径。肠外给药仅用于特定的临床情况。由于安全性和最低的监测要求，胆钙化醇受到青睐。骨化二醇可在某些情况下使用，而骨化三醇应仅限于活性代谢物在体内不易产生的特定疾病。 需要进一步研究来调查维生素 D 与不同推荐 25(OH)D 水平的关系，以及不同补充制剂在维生素 D 的多方面骨骼和骨骼外潜在影响中实现生化和临床结果的功效。