Vitamin D and Calcium Homeostasis in Bone Health Among Individuals with Disorders of Sex Development: A Review
Abstract
Background and Purpose: Bone health is critically influenced by hormonal and nutritional factors, particularly vitamin D and calcium. Vitamin D is a naturally occurring bioactive compound that functions as a hormone in the body, regulating calcium absorption and bone metabolism, thereby making it a relevant focus for clinical research within this field. This review aggregates evidence on vitamin D and calcium homeostasis in individuals with DSD, highlighting their roles in bone mineral density, osteoporosis risk, and fracture susceptibility.
Methods: A narrative review of clinical studies, systematic reviews, and guidelines was conducted, with emphasis on common DSD subtypes such as TS, KS, CAH, and AIS.
Results: Hormonal dysregulation, glucocorticoid therapy, and impaired vitamin D metabolism compromise calcium balance and bone mineralization in DSD populations. These alterations significantly contribute to reduced bone mineral density and heightened the risk of osteoporosis. Although hormone replacement therapy and supplementation are beneficial, standardized DSD-specific protocols remain limited.
Conclusion: Individuals with DSD are highly vulnerable to skeletal complications due to vitamin D and calcium disruption. Routine monitoring, early hormone replacement, and nutritional support are essential. Future research should focus on longitudinal studies and evidence-based guidelines tailored to DSD.
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