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This finding was supported by a study involving patients with COPD, whereby the bb polymorphism was associated with stronger quadriceps muscles Hopkinson et al. However, not all studies have shown similar results. Grundberg et al. Women homozygous for Bsm1 BB or poly-A repeat ss were found to have higher hamstring strength than the bb or LL genotypes.

Furthermore, no significant associations were found between VDR polymorphisms and either grip strength or quadriceps strength. Similarly, Roth et al. A pathway of vitamin D action, independent of the intra-nuclear transcription process, was mooted in the s and has been characterized more recently Boland et al. Subsequently, a membrane receptor in rat chondrocytes with a higher molecular weight than the intra-nuclear VDR known as the membrane-associated rapid response steroid-binding protein MARRS Fleet, , specific for 1,25 OH 2 D, has been identified Nemere et al.

Recent evidence illustrating that the application of 1,25 OH 2 D results in the translocation of the VDR to the plasma membrane in chick skeletal muscle cells Capiati et al. While the exact mechanism of the non-genomic action of vitamin D remains a controversial and heavily researched topic, it is widely accepted that vitamin D levels have a rapid effect on the membrane calcium channels of muscle cells in numerous species Schmidt et al. As calcium is a critical modulator of skeletal muscle function Berchtold et al.

Vitamin D deficiency has traditionally been considered the domain of the elderly; however, this is changing as evidence of high rates of vitamin D deficiency is recognized in today's youth. Vitamin D deficiency is now endemic in many communities and athletes are not spared this condition. Increasingly, vitamin D deficiency is recognized as being associated with both chronic health conditions and musculo-skeletal injuries such as stress fractures; however, its potential impact on other tissues such as muscle is not well described.

The identification of the VDR, its various polymorphisms, and variable expression with aging, has provided some insight into the complex mechanisms by which vitamin D and its metabolic pathways may affect muscle function. The recognition of both genomic and non-genomic effects of vitamin D in skeletal muscle, with the resultant impact on both calcium metabolism and protein transcription, further illustrates the significance of vitamin D in muscle function.

Further clarification of the complex role of the VDR in both muscle and other musculo-skeletal tissues is required. Despite the limited evidence available at the time, athletes and trainers in the early 20th century believed that UVB radiation was beneficial to athletic performance. Accumulating evidence supports the existence of a functional role for vitamin D in skeletal muscle with potentially significant impacts on both the performance and injury profiles of young, otherwise healthy athletes.

While further research is required to evaluate the level of vitamin D required for optimal muscular function, clinicians working with athletes should be aware of the broad impact of vitamin D deficiency on the athlete.

Vitamin D should no longer be considered only to have an impact on calcium metabolism and bone morphology, but should be recognized to have a broad impact on the organism as a whole. Further epidemiological and in vitro research into the potential impact of vitamin D deficiency on muscle function, morphology and performance in young athletic individuals is required.

The author would like to acknowledge the support of Dr. Hakim Chalabi in the preparation of this manuscript. In addition, the support of Ivana Matic and Tanya Hamilton is much appreciated. The author has no financial or other conflicts of interest in the preparation of this manuscript. National Center for Biotechnology Information , U. Scand J Med Sci Sports. B Hamilton. Author information Article notes Copyright and License information Disclaimer.

Re-use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2. Accepted Jul 8. This article has been cited by other articles in PMC. Abstract Vitamin D deficiency is an increasingly described phenomenon worldwide, with well-known impacts on calcium metabolism and bone health. Keywords: IGF-1, injury, deficiency. Myopathy associated with vitamin D deficiency Myopathy associated with vitamin D deficient osteomalacia has been recognized for many years, presenting predominantly as a proximal muscle weakness or difficulty in walking upstairs Floyd et al.

Morphology Early biopsy studies Floyd et al. Age-related changes in muscle function It is well recognized that muscle strength declines with age, due to a number of contributory factors Iannuzzi-Sucich et al. Genomic actions of vitamin D Typical of steroid hormones, the binding of 1,25 OH 2 D to the VDR results in enhanced transcription of a range of proteins, including those involved in calcium metabolism Fleet, Open in a separate window.

Non-genomic effects of vitamin D on muscle A pathway of vitamin D action, independent of the intra-nuclear transcription process, was mooted in the s and has been characterized more recently Boland et al. Conclusion Vitamin D deficiency has traditionally been considered the domain of the elderly; however, this is changing as evidence of high rates of vitamin D deficiency is recognized in today's youth. Acknowledgments The author would like to acknowledge the support of Dr.

References Adams G. Insulin-like growth factor in muscle growth and its potential abuse by athletes. Br J Sports Med. The impact of clothing style on bone mineral density among post menopausal women in Morocco: a case-control study. Biomed Central Public Health. Effects of ultraviolet radiation on physical fitness. Arch Phys Med. Teenage girls and elderly women living in northern Europe have low winter vitamin D status.

Eur J Clin Nutr. Viral mediated expression of insulin-like growth factor blocks the aging-related loss of skeletal muscle function. Proc Natl Acad Sci. Am J Phys End Met. Calcium ion in skeletal muscle: its crucial role for muscle function, plasticity, and disease. Phys Rev. Interstitial IGF-1 in exercising skeletal muscle in women. Eur J End. Assay variation confounds the diagnosis of hypovitaminosis D: a call for standardization.

J Clin End Met. Low vitamin D status despite abundant sun exposure. J Clin Invest. In situ detection of 1,dihydroxyvitamin D 3 receptor in human skeletal muscle tissue. Histochem J. Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial.

J Bone Miner Res. Muscle strength in the elderly: its relation to vitamin D metabolites. Arch Phys Med Rehabil. Vitamin D receptor expression in human muscle tissue decreases with age. Where do we stand on vitamin D? Effect of vitamin D on falls: a meta-analysis. Am J Clin Nutr. Estimation of optimal serum concentrations of hydroxyvitamin D for multiple health outcomes.

Avian muscle cells as targets for the secosteroid hormone 1,dihydroxy-vitamin D 3. Mol Cell Endocrinol. The human gene map for performance and health-related fitness phenotypes: the — update. Med Sci Sports Exerc. A higher dose of vitamin d reduces the risk of falls in nursing home residents: a randomized, multiple-dose study.

J Am Geriatr Soc. Effects of vitamin D supplementation and exercise training on physical performance in Chilean vitamin D deficient elderly subjects. Exp Gerontol. Athletic performance and vitamin D. J Cell Biochem. Vitamin D in childhood and adolescence. Postgrad Med J. Vitamin D and skeletal muscle tissue and function.

Mol Aspects Med. Estimates of optimal vitamin D status. Osteoporos Int. Vitamin D supplementation improves neuromuscular function in older people who fall. Age Ageing. Association between serum concentrations of hydroxyvitamin D 3 and periodontal disease in the US population. Effect of vitamin D replacement on musculoskeletal parameters in school children: a randomized controlled trial.

Deletion of vitamin D receptor gene in mice results in abnormal skeletal muscle development with deregulated expression of myoregulatory transcription factors. Rapid, membrane-initiated actions of 1,25 dihydroxyvitamin D: what are they and what do they mean? J Nutr. Myopathy in chronic renal failure.

Q J Med. Exposure to sunlight and vitamin D deficiency in Saudi Arabian women. The role of vitamin D in cancer prevention. Am J Public Health. Association between hydroxy vitamin D levels, physical activity, muscle strength and fractures in the prospective population-based OPRA Study of Elderly Women. Quadriceps and grip strength are related to vitamin D receptor genotype in elderly nonobese women.

Prospective study of predictors of vitamin D status and cancer incidence and mortality in men. J Natl Cancer Inst. Hypovitaminosis D myopathy without biochemical signs of osteomalacic bone involvement. Calcif Tissue Intl. Changes in muscle mass and phenotype and the expression of autocrine and systemic growth factors by muscle in response to stretch and overload. J Anat. Research on mechano growth factor; its potential for optimising physical training as well as misuse in doping. Prevalence of vitamin D deficiency among healthy adolescents.

Arch Pediatr Adolesc Med. Reasons for the degeneration of ageing skeletal muscle: a central role for IGF-1 signalling. Genetic variation in the human vitamin D receptor is associated with muscle strength, fat mass and body weight in Swedish women. Eur J Endocrin. Meta-analysis of vitamin D receptor polymorphisms and type 1 diabetes: a HuGE review of genetic association studies.

Am J Epidemiol. Serum hydroxyvitamin D and bone mineral density in a racially and ethnically diverse group of men. J Clin Endocrinol Met. Vitamin D insufficiency: disease or no disease? Vitamin D deficiency and causative factors in the population of Tehran.

BMC Public Health. Subclinical vitamin D deficiency is increased in adolescent girls who wear concealing clothing. Faster, higher, stronger. A history of doping in sport. Bookfaster, higher, stronger. New York: The Free Press; Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc.

Vitamin D deficiency. New Engl J M. Vitamin D receptor genotypes influence quadriceps strength in obstructive pulmonary disease. J Gerontol. Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Prevalence of saracopenia and predictors of skeletal muscle mass in healthy, older men and women. Electromyography in nutritional osteomalaic myopathy. J Neurol Neurosurg Psychiatry. Vitamin D deficiency, muscle function, and falls in elderly people. Calcium and vitamin D supplementation decreases incidence of stress fractures in female navy recruits.

Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Effects of vitamin D supplementation on strength, physical performance, and falls in older persons: a systematic review. Steroid receptor coactivator 3 maintains circulating insulin-like growth factor 1 IGF-1 by controlling IGF-binding protein 3 expression.

Mol Cell Biol. The Dalmatian town Biograd na Moru is situated in the middle of a row of coastal towns and only about 30 km away from Zadar. Thanks to its central location, the town, in which former Croation kings received their crown, is the ideal starting point for skippers and mariners and has a marina with a size that comes up to these needs.

Not far away there are three national parks: Paklencia and Krka on the mainland, the Kornati-islands with the natural preserve Telascica on Dugi Otok. Lake Vransko Jezero, the largest freshwater lake in Croatia, is also only 7 km away. The holiday resort Crvena Luka is situated about 3 km to the southeast of Biograd.

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