In recent years the possible multiple positive effects of vitamin D (antineoplastic, cardioprotective, immunomodulatory, etc.) have aroused growing interest and an increase in scientific (and non-scientific) publications on the subject. However, uncertainties about its usefulness in the prevention of osteoporosis have also been raised, following discordant results in the literature, beyond any reasonable doubt on extra-skeletal effects.
Osteoporosis has a burdensome impact on the healthcare system: in Italy approximately 3.5 million women and 1 million men are affected by the disease. Incidence increases with age (the steady ageing of the population leads to more cases). From age 50, the incidence of fragility fractures increases progressively, becoming comparable to that of stroke and breast cancer 1. Annual costs attributable to such fractures (acute management and long-term disability) grow with the ageing of the population. What is needed is an acceptable prevention strategy that makes the best use of available resources.